Our bloated NHS - it’s beyond ridiculous now.

MerylStreep

icanhandthemback
Re IT connectivity. We can do all these wonderful procedures but I can have an ecg reading done at my surgery where my Dr isn’t happy with the results so sends me to A&E to see someone whereby I’m given another ecg because the hospital can’t connect with my surgery to get the reading that was taken 30 minutes before.
You couldn’t make it up, could you ?

That's partly because there isn't the funding to put integrated systems in place.

There isn't even the funding to upgrade the IT in the system. Do you remember when the NHS was hit by a ransom virus a few years ago and it was discovered that a huge number of computers were running on obsolete Windows XP? I wonder if they've ever been upgraded?

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?

ref OakDryad 11.32.38

Interestingly, one of the criticisms which has been coming out of the Messenger report (and others) is that the NHS is highly regulated from the centre (ie government). Local managers aren't given much freedom to innovate, so essentially become mere administrators, responsible for ensuring their local areas run smoothly. They are so overwhelmed by regulations from government that they have almost no leeway to do anything else, even if they can see that something isn't working for them. Being an EDI Manager is a huge job, with serious repercussions if equality isn't heeded. The standard pay is about £45-50,000, not £90,000, which is at the bottom end for similar jobs in large private companies

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.

growstuff

kittylester

Not so much shortage of funding as mismanaged funding

Precisely this Laura. Including an oversupply of 'managers'.

So how come private companies have, on average, three times as many managers for the number of employees?

Oh, FGS, growstuff. Stop trying to blind people with facts...

So people are having to go to food banks, having to choose between eating and heating, and now the right wingers want them to conjure up money to pay for health insurance. What next, pay insurance to send their children to school? Just how much has to be taken away before the right wing are satisfied?

icanhandthemback
Re IT connectivity. We can do all these wonderful procedures but I can have an ecg reading done at my surgery where my Dr isn’t happy with the results so sends me to A&E to see someone whereby I’m given another ecg because the hospital can’t connect with my surgery to get the reading that was taken 30 minutes before.
You couldn’t make it up, could you ?

Toodly toot toot!

Perhaps two too many ?

Too many

I don’t get the impression that anyone on here thinks that change can happen without managers. There seems to be a feeling from some that there are two many tiers of management.

LauraNorderr

Not all departments are managed well. Take procurement as an example. Shortage of PPE at the outbreak of a major pandemic was a disgrace not all down to government.

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

kittylester

^Not so much shortage of funding as mismanaged funding^

Precisely this Laura. Including an oversupply of 'managers'.

So how come private companies have, on average, three times as many managers for the number of employees?

How does anybody who thinks changes are needed think they will happen without managers?

Ilovecheese

Didn't it have an overhaul when the coalition Government came in. The "top down" overhaul that David Cameron said was not going to happen.
Before the coalition the country was very positive about the NHS, about 75% wasn't it.
So let's think what has possibly happened since then.

The NHS has had two major restructures since 2010. The first was the overhaul Cameron said would never happen. It's in the process of the second. Google "Integrated Care System", which will mean many people will lose their local facilities and adds another layer.

Yes MaizieD, missed appointments is a huge problem creating waste.
Perhaps no shows should be billed unless they can show that they weren’t informed. In my neck of the woods we are reminded via mobile phone about hospital, dental and even specsaver appointments a week before, the day before and on the day if an afternoon appt. I’m sure GP surgeries could set up such a system quite easily.

MissAdventure

You mean like the ones people didn't even know they had?

It would take some research to know if that was a common problem or only one experienced by a few

Deliberate mis reading volver and making assumptions based on your prejudices.

Perhaps you can explain what my prejudices are kittylester? Given that I have never worked in the NHS but I have worked in organisations where all the people on the factory floor thought the organisation had far too many managers and they all needed to be got rid of?

And then those who were invited to join the board as reps for the organisation lasted a couple of weeks before they realised it wasn't quite as straightforward as they thought?

And you are as entitled to your opinion as I am to mine, Glorianny.

You mean like the ones people didn't even know they had?

Experience is as relevant as research imo.

It just isn't.

Experience only presents one with a tiny part of the picture, viewed from only one angle; research gives a far wider and objective view.

On the other hand, thorough research will take into account the experiences of the service user and the service providers where it is appropriate.

If 'research' into a particular service were to find that only 2 out of 1,000 users had had a bad experience would that make it a badly run service or a good one?

It was certainly bad for the 2 people who had the bad experience, but a decent service would have systems in place to deal with this. Probably one of those much despised 'managers'

And while people are fixating on waste, how about when it works in the reverse direction with thousands upon thousands of missed appointments each year?

icanhandthemback

It seems to me that we all agree that the NHS is broken but we have different ideas of how it can be fixed and a lot of that depends on your political persuasion. If you just look at the disagreements on here you can see how difficult it must be for political parties to resolve the problems and keep the public happy. I suspect that there is a multi pronged approach needed but party politics dictates that one concentrates on only throwing money at the problem, the other works on cutting waste.
Sadly, I have been heavily involved in using the services the hospitals and GP's provide as the congenital condition our family suffers from mean quite a lot of operations, trips to A&E, fighting to get treatment and getting medical professionals to understand how the condition affects us. Slap in dash of autism, mental health conditions, dyspraxia and ADHD (all of which are comorbidities of the condition) we have seen a wide variety of services over the years and noticed the changes, good and bad. We are not experts but when we see the same "pathways" being insisted upon for each member of the family, with long waiting lists, professionals who know less about the condition than you do (and admit it) then you start to question whether the system is working optimally. People's lives are being put on hold...usually when they are young so it has all sorts of knock on effects, then the frustration is overwhelming. Referrals to London hospitals or different "specialist" services have nearly always had to start from the beginning because the full records are not available. It is at best inefficient, at worst negligent if these systems are supposed to be joined up. It is no wonder we feel we should be believed and are suspicious of the research.
If it was only the NHS who each had their own systems with bolt on bits which don't quite mesh, are often very expensive to make changes to in order to get them enmeshed only to find that any further changes can't be done so they have to be replaced, it wouldn't be so bad. My family are heavily involved in other public institutions working within the IT sectors and the stories of wasted IT purchases and adaptions have to be seen to be believed. Most of the time it seems that the people who are doing the buying are not Systems trained and will believe the Sales People over the people who know about coding/integration and the like within their own organisation. My husband was also involved with the IT for HR and his biggest complaint is that the people doing the liaising with the Sales people didn't know the right questions to ask and understood the answer even less if you gave them the questions. Add in the fact that each area buys their own systems and you have a lack of joined up thinking that causes massively wasted funds.

I don't think the NHS is broken. I think it survived Covid and got us through lockdown remarkably well.
I think it is massively underfunded and is being deliberately underfunded so the Tories can convince you it is broken. I posted earlier links Tory MPs have with private health care. Do you really imagine those links don't influence what they do for the NHS?
A look at this might help www.kingsfund.org.uk/publications/spending-and-availability-health-care-resources?gclid=CjwKCAjwj42UBhAAEiwACIhADmLeARgFZVqNoOzjY2i7dgdZD8mlWuYVEupike54zkQD4b_TJTgRRRoCrHgQAvD_BwE
In 2018 only Poland had fewer doctors and nurses per head of the population than the UK.
We are usually in the bottom few of any of the standards referred to.
And we are bottom for CT and MRI scanners.
This after 12 years of Tory rule.
Those of us who remember what things were like when Blair came to office might just be forgiven for thinking we've been here before!

Just remembered something. For years a cohort of us med secs occupied one area of office space. Two secretaries to an office. On tiny room with no windows, cubby holes for the post was designated a rest room/coffee area/lunch spot. It had 4 small chairs against the wall, ripped carpet that was taped over, peeling plaster. Someone asked for a small fridge and a microwave. No dice. One of my colleagues was having her kitchen refurbished. Her husband brought in their old ones which (fair enough) had to be checked by the hospital electricians and issued with a safe to use sticker.

My mum called in one lunchtime to drop something off for me. She was horrified by the room. Said it was shabby and disgusting that this is where we ate. I told her it was either this or eat a sandwich at our desks! Over the years we failed to register it.
?
We did ask if it could be painted perhaps? ‘No money’ we were told.

A couple of the secretaries wanted to go in over a couple of weekends to paint it. ‘Not allowed’ we were told. Some health & safety rules. Plus procurement of paint to certain standards. Blah, blah.

Other secretaries we’re against the whole concept of doing it up ourselves. Why should we give up our weekends they cried? Fair enough. Nothing got done. It just became shabbier I dare say over the years....

Then a new raft of managers took over. We were relocated, systems changed and the managers decided this long corridor with easy access to many room (some used by our consultants) was ideal for their needs. Fair dinkum.

But my goodness, you should have seen the refurbishment that corridor got! It was like that tv programme where a team of plasterers, painters, joiners descend to do a ‘makeover’. New flooring, new carpets, plush seating. Then our swipe cards no longer ‘accessed all areas’ to that corridor. The porter on the front desk just outside said to me ‘you should see the kitchen! New wall units, a dishwasher (!) (we didn’t even have a sink when we were in there - we washed our pots in the sink in the ladies loo, horrid really), an Nespresso machine.... all this was 10 years ago now.

Nothing was too good for these managers it seemed.
I doubt much has changed - in hospital Trusts up and down the land.

No personal knowledge or experience, but everyone I know who works, or has worked, for the NHS (both admin and medics) has said there are too many managers and a huge amount of waste.

Experience is as relevant as research imo.
I’m not a chef but I know a good omelette when I taste one. I’m not a surveyor but I recognise damp when I see it.
I’m sure we all vote for a political party based on our life experience, what we see and hear around us. Not many of us have had to work at Downing Street to form an opinion.