Wes Streeting about the NHS ‘failing managers’.

Just to be clear, the proposal from Wes Streeting relates to very senior managers who are accountable for performance of health services at a hospital/community scale. Most operational managers are clinicians, not non clinical managers, and without them services would grind to a halt very quickly.

Staff who support clinical services are the people who will be needed to gather and collate all the data which clinicians input into the various systems they use - these people are included in management costs, but they aren’t actually managers.

kittylester

There are too many layers of NHS managers.

And, I will say again, DH worked for the NHS for all his working life and, every time a new initiative was brought in, another layer of management was added. His last line manager didn't know what his job title meant and had to have it explained to her.

This isn't about removing layers. It's about making people more accountable for outcomes.

kittylester

There are too many layers of NHS managers.

And, I will say again, DH worked for the NHS for all his working life and, every time a new initiative was brought in, another layer of management was added. His last line manager didn't know what his job title meant and had to have it explained to her.

One of my sisters was a senior NHS manager and her experience was the opposite.

In the year or so before she was finally made redundant, her own line manager and one of the team leaders who was responsible to her left and wasn't replaced. This meant that my sister ended up trying to cover three people's jobs.

When my sister left, she was replaced by somebody on a much lower grade and without much experience. Not surprisingly, the person struggled, so after a few months new jobs were created and they ended up where they started - except the new people doing the jobs didn't have years of experience.

Where are these extra layers tho? What are their jobs? I genuinely don't know enough about the inner workings of the NHS except my GP's practice.

There are too many layers of NHS managers.

And, I will say again, DH worked for the NHS for all his working life and, every time a new initiative was brought in, another layer of management was added. His last line manager didn't know what his job title meant and had to have it explained to her.

Which sort of managers don't we need?

Generally saying "we have too many" doesn't tell us which ones are actually central to core purposes and which ones apparently "too many?"

Yes. I absolutely agree that NHS managers need to be held to account, and what is being proposed is only what has happened in education for many years, via Ofsted Inspections.
It is demeaning and distressing to receive criticism, which is then made public, but teachers are generally not responsible for large budgets,do not receive inflated salaries or control large numbers of staff.
The NHS has been unaccountable for expenditure for far too long, and much of the problem appears to lie with the managers.
Far too much of Our wonderful NHS, Our hard working nurses and Our dedicated doctors, and far too many managers. A light does need to be shone on what exactly goes on before yet more money is advanced.

growstuff

Casdon

I think what is being proposed regarding failing managers is okay.
What concerns me much more is the plan for publication of league tables about hospital performance, how comprehensive it will be, and how many number crunchers extra will be needed to administer the system if it is comprehensive. The difficulty I see is that there are lots of departments in every hospital, and to rank hospitals meaningfully it would be necessary to rank every department, all of which are interdependent. I can’t quite get my head around what the proposal actually is, and what all the implications are, including patient anxieties about ‘failing’ hospitals, which may be excellent in some departments.

What concerns me is that hospitals which take on more serious and complicated cases could be seen as 'failing' because their mortality rates are bound to be higher and they will probably spend more time with non-routine patients.

How is Streeting going to judge failure?

I know some of the data related to surgical procedures is captured already with a complexity weighting growstuff, but probably not enough to do comparison at a level higher than a specific procedure eg hospital a performs better than hospital b at a particular type of operation? (obviously there are thousands of different types of operations). I really hope we don’t end up with a league table system that increases input staffing requirements and is ultimately meaningless.

Yes Casdon lots of good questions in there!

Casdon

I think what is being proposed regarding failing managers is okay.
What concerns me much more is the plan for publication of league tables about hospital performance, how comprehensive it will be, and how many number crunchers extra will be needed to administer the system if it is comprehensive. The difficulty I see is that there are lots of departments in every hospital, and to rank hospitals meaningfully it would be necessary to rank every department, all of which are interdependent. I can’t quite get my head around what the proposal actually is, and what all the implications are, including patient anxieties about ‘failing’ hospitals, which may be excellent in some departments.

What concerns me is that hospitals which take on more serious and complicated cases could be seen as 'failing' because their mortality rates are bound to be higher and they will probably spend more time with non-routine patients.

How is Streeting going to judge failure?

FriedGreenTomatoes2

No that’s because the wokerati don’t use it like they used to love. Go Elon.

Oh yes? So who are these 'wokerati'? Aren't they allowed free speech (to post where they want) since the Great Takeover? Musk hasn't exactly shown much business acumen with Twitter/X.

I think what is being proposed regarding failing managers is okay.
What concerns me much more is the plan for publication of league tables about hospital performance, how comprehensive it will be, and how many number crunchers extra will be needed to administer the system if it is comprehensive. The difficulty I see is that there are lots of departments in every hospital, and to rank hospitals meaningfully it would be necessary to rank every department, all of which are interdependent. I can’t quite get my head around what the proposal actually is, and what all the implications are, including patient anxieties about ‘failing’ hospitals, which may be excellent in some departments.

Exactly so, Maizie.

FriedGreenTomatoes2

Yes, I agree Wyllow more medical staff but less layers of bureaucracy! That’s where Streeting is on the right track.

Streeting's comments, BTW, don't support the belief that he wants to eliminate layers of bureaucracy. He's talking about eliminating 'rotten apples' not cutting management roles.

Wes Streeting is probably correct in identifying this problem, but it happens in just about every institution or company. It's certainly no justification for eliminating large numbers of NHS managers.

Report after report identifies lack of good management as being a big problem in the NHS, where, because of the shortage engendered by years of underfunding, clinical staff are being asked to carry out management tasks for which they are not qualified, have no desire to undertake and which mean they have less time available to do the job for which they are trained.

Random stories and beliefs about NHS management are no substitute for the conclusions of a properly conducted study.

If Musk does what he threatens to do it will be a disaster for the USA.

Yes, I agree Wyllow more medical staff but less layers of bureaucracy! That’s where Streeting is on the right track.

No that’s because the wokerati don’t use it like they used to love. Go Elon.

FriedGreenTomatoes2

Elon Musk got rid of 80% of staff Wyllow when he took over Twitter. (Now X).
Said “free speech doesn’t need so many moderators”. 😁

Maybe that's one of the reasons Twitter (X) has lost approximately 75% of its value since Musk bought it.

FriedGreenTomatoes2

Elon Musk got rid of 80% of staff Wyllow when he took over Twitter. (Now X).
Said “free speech doesn’t need so many moderators”. 😁

I don't see the relevance of that to our NHS in anyway at all. The NHS is our key health provider and we need more doctors and nurses not less.

We also need to wait or Monday to hear or indeed properly discuss more than those "headlines", ie other measures planned.

Elon Musk got rid of 80% of staff Wyllow when he took over Twitter. (Now X).
Said “free speech doesn’t need so many moderators”. 😁

Yes to the O/P.

a huge no to Elon Musk, who promotes hatred and division and has been appointed to politicise and shred a non political civil service and would rip up our NHS into the private sector. Proud of our NHS, leave us alone Musk, USA style so called healthcare.

I’m with Wes Streeting on this. A lot of money is wasted. More money in itself isn’t the answer any more. Value for money is.

Do you not agree with public service?
Would you prefer the American way of every man for himself?

What about the very highly paid Amanda Pritchard from NHS England? She’s always under the bluddy radar.