Gransnet forums

News & politics

Our bloated NHS - it’s beyond ridiculous now.

(521 Posts)

GNHQ have commented on this thread. Read here.

Urmstongran Mon 16-May-22 10:07:56

At the moment, only about one third of NHS staff are doctors or nurses (roughly 450,000 out of 1.4million employees).

The new analysis shows that the number of officials working in the Department of Health and NHS England has more than doubled in two years, with even sharper rises seen at the most senior levels. Meanwhile the number of nurses rose by just seven per cent, thinktank the Policy Exchange found.

Its experts said the trends showed an “astonishing” explosion in central bureaucracy, calling for an urgent review and action to slim down and streamline its workings.

The findings come ahead of a review of leadership in the NHS by a former army general.

Sir Gordon Messenger has been sent in by Sajid Javid, the Health Secretary, amid concern over the quality of management in the NHS as the service faces the biggest backlogs in its history.

icanhandthemback Tue 17-May-22 12:02:15

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.

kittylester Tue 17-May-22 11:51:15

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

The (not senior) manager didn't know what his job title meant not what was involved. Quite why he needed 4 managers above him when he was the only person doing his job, goodness only knows.

I didn't say I, or Dh, were angry. Bemused would cover it and, as he was the only one doing it, it would be weird for them to make decisions about it. It either was a job or it wasn't.

Chewbacca Tue 17-May-22 11:48:34

LauraNorder is correct in her observation regarding NHS procurement depts. When NHS Trusts, and departments within them, merge or amalgamate, which they quite often do, new logos, new stationary and signage are all changed at eye watering costs. I couldn't believe the wastage.

volver Tue 17-May-22 11:39:58

I really should stay off this thread, its not good for my blood pressure.

So a senior manager asked your DH about his job and you are angry about that? They actually asked a person doing the job what their job entailed and you are complaining about that? But if they had just sailed ahead and made decisions without consulting your DH, how would that have been? Would that have been more acceptable?

Or maybe you think the senior managers should only be people who have done you DH's job and so know all about it? So then who will do your DH's job if they are all made into managers?

Honestly, I can't cope. Time for lunch.

kittylester Tue 17-May-22 11:35:35

But do people writing reports actually gave experience of being managed in the NHS?

DH was assigned a (nother) manager - there were 3 more above her - who asked him to come in for a chat. The chat was partly because she didn't know what his job title meant.

So, no auntie's, hairdressers or cousins involved at all. And how rude to assume no one else knows anything.

GrannyGravy13 Tue 17-May-22 11:33:11

Actually I think that the consensus of opinion on this thread is something needs to be done to heal the NHS

The contentious part is what that something is

Urmstongran Tue 17-May-22 11:32:54

LauraNorderr

Not so much shortage of funding as mismanaged funding. Incredible waste is obvious in many hospitals.
Just one example, we have used our nearest hospital for 30 years, I can remember at least twelve complete changes of the decor of the arrival area, not bigger, not more efficient, not more hygienic, not even more pleasant just a big change of colour scheme, newly painted, new seating, flooring, wall hangings, reception desks, lighting, plastic plants and no doubt a huge design bill.
Same in the wards and corridors. One year mixed wards in blue, then small individual cubicles in a variety of colours, then small single sex wards of six in different colours, then back to mixed wards.

Oh god, yes, this LauraNorder. Over the years when I worked (admin only) in our local District General Hospital, every raft of new management would re-invent the wheel. Colours, signage - money was no object. Doubt it affected patient outcomes.

OakDryad Tue 17-May-22 11:32:38

I wanted to chip in about diversity and comments made earlier in the thread alleging that resources allocated to this were a waste. Apologies if this has been explained. I have leapt over bits of the thread where things got too personally combative at the expense of factual argument.

Every NHS Trust must have an equality, diversity and inclusion policy to comply with the requirements of the Equality Act 2010 especially with regard public service provision. It’s the law and is not only about staff. Policy must have action plans on both Patient Equality, Diversity and Inclusion as well as Staff Equality, Diversity and Inclusion, Many are published online so people here can look them up for themselves.

These policies recognise that people are different and their care needs in hospital will be different taking into account age, disability, gender, faith, cognitive ability, mental health, ethicity etc.

If you are admitted with a broken leg your overall care needs will be different depending on you are, say, young, old, disabled by dementia, hearing-impairment, sight-impairment, have faith requirements etc etc.

EDI managers seek to work with specialists and specialistic agencies in those fields to improve the patient experience by planning and implementing policy including structural changes to hospital layout and signage, staff awareness and training and a host of other factors.

There might be an argument for there to be a national policy rather than individual trusts writing their own. You’ll see if you look at some of those online that they vary in overall approach, length and detail. On the other hand, local trusts need to take into account the specific needs of their particular communities in prioritising change.

volver Tue 17-May-22 11:27:41

This world is in a mess, I think.

We have reports and analyses from people who know what they are talking about, that say the NHS is undermanaged.

Then we have people who love to tell us that their auntie's hairdresser's cousin had a bad experience so obviously there are too many managers.

And these people have no idea that they are being manipulated to think that way by the government. We seem to have had too much of experts, right enough.

(I really should stay off this thread.)

kittylester Tue 17-May-22 11:23:56

I think it's confirmation bias, volver. Ignore the information that disagrees with your beliefs.

Or believe what one has seen.

LauraNorderr Tue 17-May-22 11:21:15

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.

AGAA4 Tue 17-May-22 11:17:14

My DD is an oncology nurse/manager. There are many with medical qualifications who are also managers.
Should we get rid of all those medically qualified managers, many who work with patients too as does my DD?

MaizieD Tue 17-May-22 11:09:35

volver

^Including an oversupply of 'managers'.^

Really kittylester? Several posters have given evidence of how that is not the case. Do you have evidence to the contrary?

I think it's confirmation bias, volver. Ignore the information that disagrees with your beliefs.

volver Tue 17-May-22 11:06:38

Including an oversupply of 'managers'.

Really kittylester? Several posters have given evidence of how that is not the case. Do you have evidence to the contrary?

kittylester Tue 17-May-22 11:02:40

Not so much shortage of funding as mismanaged funding

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

MaizieD Tue 17-May-22 11:01:23

GagaJo

Yes, for those on here asking for suggestions, how about we just go with BJ's idea of 50,000 more nurses? Sounds like a very good start to me.

More beds would probably help too.

More beds?

Oh, GagaJo, have you forgotten about 40 new hospitals? grin

GagaJo Tue 17-May-22 10:57:41

Yes, for those on here asking for suggestions, how about we just go with BJ's idea of 50,000 more nurses? Sounds like a very good start to me.

More beds would probably help too.

Callistemon21 Tue 17-May-22 10:53:44

MaizieD

Callistemon21

The weird thing is that everyone seems to think that the NHS suffers from too much funding.

I hadn't noticed that everyone on the thread thought that at all
confused

Nit picking, Callistemon grin

I was generalising.

Not nit picking
Just facts!!

?

LauraNorderr Tue 17-May-22 10:47:09

Not so much shortage of funding as mismanaged funding. Incredible waste is obvious in many hospitals.
Just one example, we have used our nearest hospital for 30 years, I can remember at least twelve complete changes of the decor of the arrival area, not bigger, not more efficient, not more hygienic, not even more pleasant just a big change of colour scheme, newly painted, new seating, flooring, wall hangings, reception desks, lighting, plastic plants and no doubt a huge design bill.
Same in the wards and corridors. One year mixed wards in blue, then small individual cubicles in a variety of colours, then small single sex wards of six in different colours, then back to mixed wards.

MaizieD Tue 17-May-22 10:42:26

Callistemon21

^The weird thing is that everyone seems to think that the NHS suffers from too much funding^.

I hadn't noticed that everyone on the thread thought that at all
confused

Nit picking, Callistemon grin

I was generalising.

varian Tue 17-May-22 10:40:25

I wonder how much of NHS funding goes to outsourced services, private health care providers and staff agencies?

Callistemon21 Tue 17-May-22 10:39:43

The weird thing is that everyone seems to think that the NHS suffers from too much funding.

I hadn't noticed that everyone on the thread thought that at all
confused

MaizieD Tue 17-May-22 10:38:02

Excellent post at 7.28 Casdon ?

DaisyAnne Tue 17-May-22 10:37:03

I suggest that it should have its funding returned to its proper level, recruit back to its proper staffing levels ,and be allowed to run like that for a few years before making any decisions about radical change.

A period of recovery seems like a very good idea Maizie

MaizieD Tue 17-May-22 10:35:07

GrannyGravy13

Chewbacca &’LauraNorder I agree and posted as much yesterday only to be told I didn’t know what I was talking about…

It was a very frustrating day on this thread yesterday..

I am sure that there are areas which need change, procedures which need to be tightened, etc. but first of all it needs to be properly funded to allow it to be running more normally. Then time is needed to thoroughly assess what is going wrong and why. We don't need knee jerk reactions and change for the sake of it.

The weird thing is that everyone seems to think that the NHS suffers from too much funding. In fact, it's been cut to the bone and now everyone is complaining about its poor performance. What does that tell us?