Our bloated NHS - it’s beyond ridiculous now.

But holding people to account is part of managing.

What is it about "managers" and "experts" which people so dislike?

If anything, the UK has too few managers and experts and has been tootling along with too little direction and strategy for decades (or longer).

It's probably true that some managers are under-skilled and the systems they work with aren't fit for purpose, but that doesn't mean there are too many managers. It means that better training is needed.

Who manages the managers?

MissAdventure

Who manages the managers?

The CEO, who is accountable to the Secretary of State.

growstuff Is this the number you are looking for?

£11.8bn for 2019-20 and £13.8bn for 2020-21.

This BMA report:

www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/commissioning/nhs-outsourcing

Spending on [Independent Service Providers] specifically increased in 2020/21 due to the pandemic

The increase in ISP spending during the pandemic reflects the historic lack of NHS funding which led the Government to contract with ISPs to bolster NHS capacity.

Spend on ISPs was £2 billion higher in 2020-21 compared to the previous year, where spend was £11.8 billion.

Thanks! I'll read it.

Shortage of funding causes inefficiency. It's so blindingly obvious that I can't see how people manage to miss it. Unless they are ignoring it to suit their political agenda.

Procurement is one area which needs to be more efficient. It's not ust recently that the NHS has been overcharged and even defrauded. Is this because of a lack of procurement managers or inefficiency and a lack of basic common sense in working practices?

Actually, my husband was the expert. As evidenced by the fact that his manager didn't understand his job title and he was the only person doing it!

I don't dislike managers but I have just proved that some are unnecessary.

And, I certainly don't dislike experts - I'm married to one of them and he's very likeable.

growstuff

kittylester

Who said all managers needed to be got rid of?

All organisations are different so your experience has no relevance to the NHS.

DH didn't need managing at all in reality. In the early days, there was one manager overseeing all roles similar to his - heaven knows how many there are now. But at least she knew what his job was.

Being overmanaged was one of the reasons dh stopped working, aged 71, and now no one in the county carries out his fairly vital role.

IMO, experience is either a small part of the picture or a small example of how things are wrong.

NO hairdressers, aunts, cousins, neighbours were consulted to acquire this knowledge.

Are you serious that he didn't need managing? Should he not have been accountable to someone?

Are you serious that he didn't need managing? Should he not have been accountable to someone?

Perhaps you should re-read kittylester's post?

X post!!

Procurement had been outsourced to a quango, operating outside the NHS.

Not 100% accurate there growstuff. In some NHS Trusts, yes they outsourced, have but not all. And in some of the Trusts who did outsource their procurement, some of them took them back in house due to the costs involved and the inefficiency of outsourcing. In addition, some of the Trusts left only certain parts of their procurement with the outsourced companies and retained others within their finance departments.

Why should I re-read it Callistemon?

I understood it. She said her husband didn't need managing, but he did.

Is this what "piling on" looks like? Should I have a moan to GNHQ?

kittylester

Who said all managers needed to be got rid of?

All organisations are different so your experience has no relevance to the NHS.

DH didn't need managing at all in reality. In the early days, there was one manager overseeing all roles similar to his - heaven knows how many there are now. But at least she knew what his job was.

Being overmanaged was one of the reasons dh stopped working, aged 71, and now no one in the county carries out his fairly vital role.

IMO, experience is either a small part of the picture or a small example of how things are wrong.

NO hairdressers, aunts, cousins, neighbours were consulted to acquire this knowledge.

I'm assuming that this is directed at me kittylester, with the dismissive and rude comments about other experiences being irrelevant.

But my experience is not irrelevant. As I have said often, I've never worked in the NHS so wouldn't presume to tell them how to run the business, although others with only a slender attachment to the NHS seem to think they know exactly what's wrong.

But what I do know is this; in large organisations, the people at the coalface often think they know exactly how to run the business and that managers have no idea. Especially those managers with university degrees, they're the worst.

Your DH is clearly an expert in whatever it is he does. But that doesn't make him an expert in resource management, service delivery, budget control or whatever else it was his managers were doing that was outside his area of expertise. Maybe his managers were incompetent, who knows. But anyone says they don't need managing within a large organisation, I just think "aye, right". Big organisations have objectives and people saying that they don't need to know what's expected of them are probably best out of it anyway.

Chewbacca

^Procurement had been outsourced to a quango, operating outside the NHS.^

Not 100% accurate there growstuff. In some NHS Trusts, yes they outsourced, have but not all. And in some of the Trusts who did outsource their procurement, some of them took them back in house due to the costs involved and the inefficiency of outsourcing. In addition, some of the Trusts left only certain parts of their procurement with the outsourced companies and retained others within their finance departments.

Interesting. Thanks for the info. I thought NHS Supply Chain was responsible for all procurement, even when it subsequently outsources. NHS Supply Chain is (I think, but could be wrong) currently owned by Unipart.

en.wikipedia.org/wiki/NHS_Supply_Chain

www.supplychain.nhs.uk/suppliers/existing-supplier/#:~:text=The%20new%20NHS%20Supply%20Chain,stock%20position%20of%20your%20products

No, i thought you didn't seem to understand it.

kittylester's DH did have a manager, someone he was answerable to; however, the manager did not understand either his field of expertise or his brief.

It seems he would have been perfectly able to manage himself and she was superfluous to needs.

I may have read this wrong of course, if so I'm sure kittylester will correct me.
I won't take it as a pile-on if she does.

Rather like the sister in charge of two surgical wards who was not able to admit me and another patient before the bed manager approved it. We had to wait in a storeroom for two hours.
The very experienced sister was very angry and said she'd managed her wards perfectly well for years until, she said "they appointed a 21 year old manager to tell me what I know already".

I was going to avoid anecdotal evidence but it seemed apt.

kittylester

Actually, my husband was the expert. As evidenced by the fact that his manager didn't understand his job title and he was the only person doing it!

I don't dislike managers but I have just proved that some are unnecessary.

And, I certainly don't dislike experts - I'm married to one of them and he's very likeable.

No, your DH's manager was necessary and it was part of his job to understand how your DH's work fitted into the systems for which he was responsible. This would have been especially important, as your DH was doing a job which nobody else understood. It was your DH's responsibility to ensure that the value of his work to the organisation was understood.

One of the real problems in large organisations is that there are people who have been doing jobs for decades - because that's how it's always been - but nobody has looked at whether the job is still valid and maybe the task could be done more efficiently. I have no idea whether your DH was one of those, but at the very least he had a duty to explain what he was doing and why it was important.

But I did understand it. You thought wrongly on this occasion.

I have managed people whose job I would have no idea about. I would have no idea about how to even start doing what they were doing. I had salesmen in my team. I had a person who looked after online marketing. Both things a mystery to me, I wouldn't know where to start. But I knew what I expected their outcomes to be. A manager's job isn't to be the best person on their team at every job, or to know every job backwards. It's to build and manage a team to produce the results an organisation needs.

So anybody in an organisation who thinks they don't need a manager is a person who doesn't belong in an organisation. Maybe they should leave and become self employed.

growstuff

But I did understand it. You thought wrongly on this occasion.

Managerial roles can always be justified by some, usually those with a vested interest.

What a shame that the majority on here are retired, no doubt that could sort out the NHS in a shake ????

Dead right calistemon!

A bit like the sister in your anecdote.

It doesn't seem to fit the rhetoric does it?

Callistemon I'm sorry you had to wait in a storeroom for two hours, but that ward sister didn't know (because it wasn't her responsibility) whether the spare bed in her ward was needed more urgently by somebody who was at that moment in A&E. Unfortunately, people who always seems to think they know best, but in reality don't have an overview, cause systems to fail.

kittylester

Dead right calistemon!

A bit like the sister in your anecdote.

It doesn't seem to fit the rhetoric does it?

I don't understand what you mean. If every ward sister acted independently outside her remit, there would be chaos.

This is laughable.

The vested interest is usually that they want to be organisation to be successful.

Maybe there are too many managers in parts of the NHS, I don't know. But the immediate chorus of "too many managers, some of them just 21, I know what I'm doing" just betrays how little people really do know about running organisations.

GrannyGravy13

What a shame that the majority on here are retired, no doubt that could sort out the NHS in a shake ????

I'd give it a go.