Wes Streeting about the NHS ‘failing managers’.

Referring back to my previous post, I was a middle manager in a non-clinical setting with numerous layers of senior and senior executive managers above me. My team spent a huge amount of time collating data for senior managers to present at meetings to other senior managers and arm length organisations on such things as diversity. Much of this data was duplicated in different formats for different people and was frankly meaningless for the most part.
The NHS is not one organisation but is made up of over 200 different trusts and, during my time, each had their own policies and paperwork and each had someone responsible for creating these. If these had been centralised so much money could have been saved and spent on the more important medical and clinical staff. I very much doubt that this has changed today.

These are the key messages from a paper by the King's Fund with the title "Why management matters so much for the success of the NHS 10 Year Health Plan":

www.kingsfund.org.uk/insight-and-analysis/long-reads/why-management-matters-nhs-10-year-plan

Key messages

-High-calibre, well-trained management and clinical leadership are critical to the delivery of the ambitions of the 10 Year Health Plan.

-There is a pressing need to professionalise, invest in and support NHS management within a system of regulation that will assure core standards, a code of conduct, training and continuing professional development.

-The NHS is under-managed in the international context, and this poses significant risks to the ability of the service to make desired improvements.

-The centre of the NHS must create and model the conditions within which local leaders and senior managers are able to support clinical teams and staff in making local service improvements.

-The local NHS leadership community must step up and act on the changes now needed to management training, support and professionalisation.

-NHS management really matters. Instead of being denigrated, it should be supported and celebrated within a proportionate framework of professional development and accountability.

I've seen other reports that the NHS is under-managed, so this isn't a "one off". The problem seems to be that "managers"'s role in the NHS is more about hitting targets dictated from the centre rather than being able to deliver solutions based on local needs. Managers aren't being allowed to manage - they're more like team leaders. There's very little innovation coming from the "chalk face".

The motivation of senior managers in any public service is very different from a private business.

Sarnia

Let's have some action, then. I worked in the NHS for 17 years and in that time saw a huge rise in managers and latterly, managers for diversity and inclusion (yawn) all on high salaries.
The NHS needs a thorough root and branch overhaul and millions could be saved. No need to keep increasing the amount given to the NHS.

I do remember being in hospital and just beyond my room were double doors and a lot of empty rooms along the corridor beyond there.
The Sister told me they had requested to use those rooms for patients as they were desperate for more space but that they had been designated for the increased number of managers they were taking on.
That was 20 years ago.

The BBC reports that the national waiting time for an ADHD assessment and treatment is 8 years and some NHS areas have closed entry to the waiting list. Some 5% of children are estimated to suffer from ADHD.

This is a serious matter, How did the Tories let it get to this stage and what is Streeting doing about it?

Inclusivity a diversity issues usually raise anger or yawns. It’s easy to dismiss this area as unnecessary.
Yesterday I heard radio reports of non white staff in the nhs and agencies employing carers expressing genuine concern about the increase in racist abuse. Patients refusing treatment by non white oractitiiners.

Even more concerning were the reports that nhs staff were now more likely to be racist to non white colleagues. Remember, you aren’t one of us allegedly being directed .

Problem Sarnia could be 'who decides where the cuts should be?'
If it is the Managers, who many feel are too numerous, then would they be willing to prune their own ranks?

Let's have some action, then. I worked in the NHS for 17 years and in that time saw a huge rise in managers and latterly, managers for diversity and inclusion (yawn) all on high salaries.
The NHS needs a thorough root and branch overhaul and millions could be saved. No need to keep increasing the amount given to the NHS.

Fried, why do you think the drug addled, misogynistic, 'far white' Elon Musk would be able to help the NHS?
What improvements has he made anywhere?
Many of the folk he sacked in his crazy DOGE purge have had to be re-employed.

Allira

Oh, my family member still has her job.
(Anecdotal, I know)

They were busier than ever during Covid.

Your family member will also know how much routine lab work is now done by AI. People are still needed to make decisions because they can't be replaced by robots (yet).

The world moves on. Think of the thousands of people employed in typing pools, which have now disappeared. The same is happening in labs.

Oh, my family member still has her job.
(Anecdotal, I know)

They were busier than ever during Covid.

Allira

I think mae13 was referring to her work as a lab technician in a hospital.

An anecdote.

I understand much lab work is now automated.

I think mae13 was referring to her work as a lab technician in a hospital.

An anecdote.

Allira

growstuff

I've spent hours inside a hospital over the last few years and lost count of the donkey workers I saw - there must have been hundreds of them! Strangely, I'm not even aware of having seen any managers.

In the labs?

Not sure what you mean. I saw hundreds of nurses, radiographers, doctors and a couple of receptionists, porters and cleaners. I didn't see any managers - they must have all been in hiding.

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”. 😁

The NHS is rather different than X. Put simply, X is a totally unnecessary money maker for the awful Elon, the NHS is essential for the health and wellbeing of our country.

growstuff

I've spent hours inside a hospital over the last few years and lost count of the donkey workers I saw - there must have been hundreds of them! Strangely, I'm not even aware of having seen any managers.

In the labs?

I've spent hours inside a hospital over the last few years and lost count of the donkey workers I saw - there must have been hundreds of them! Strangely, I'm not even aware of having seen any managers.

The minions were doing the donkey work, but there were only two of them - apparently! They must have been rushed off their feet, if there were only two of them.

growstuff

mae13

Some time ago, when I worked as a lab technician at a local hospital, a colleague idly pointed out to me one day "y'know, there's only two people in this department who haven't got the word 'Manager' on our name badges - me and you"

True enough. We were surrounded by onion-layers of clipboard wielding management types who spent an awful lot of time whizzing up and down the corridors attending (supposedly) "urgent meetings", while the non-manager minions were doing the donkey-work.

So there were actually quite a lot of non-manager donkeys?! Now I'm confused.

So there were actually quite a lot of non-manager donkeys?! Now I'm confused.

I understood mae13 to mean there were just two non-manager minions.

Wyllow3

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 agree with Wyllow.

It always amazes me that people who fail in top jobs, not just the NHS, can then slide effortlessly into top jobs in other areas.

Paula Vennells, for instance, after destroying the lives of so many people, then moved on to become Chair of Imperial College Healthcare NHS Trust.

No thank you to Musk. Nothing to do with him whatsoever.

MaizieD

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.

There may be an issue Maizie, but targeting an identifiable group makes him no better than the far-right fascists.

They need to break the NHS into smaller units so people feel they are working for identifiable aims with identifiable colleagues. Poor or unworkable environments just encourage workers to job craft. This is not because people are useless but because humans are really quite clever.

They need to start using Not For Profit organisations not outsourcing to profiteers making money out of a State run organisation. They also need to phase out PFI and start owning there own assets .

If you don't make a system workable it will not work and you cannot blame those trying for not being able to succeed in a badly constructed system.

I agree Grantanow. I've seen that often. They remove the layer with actual experience and leave the dodgy top dogs and a lot of newbies and wonder why reinventing the wheel somehow doesn't work.
That apart, the NHS is a colossal organisation with thousands of component departments and professions. Coordinating it all at all is extremely hard let alone running it efficiently.

Sacking middle managers as a group often results in losing workplace memory about bright ideas that didn't work and how to do things not covered in documentation or through short cuts. Just saying...

Astitchintime

"The Health Secretary said it was a “guilty secret” of the NHS that poor performing leaders were able to “reincarnate” elsewhere in the service"...........absolutely true and in my several decades of NHS service I have seen this happen time and time again.

I can’t agree enough. I was a middle manager in the NHS for many years and had numerous changes of managers. These consisted of directors, heads of …. Service, manager of ….. Me as middle manager and then staff below me, so 5 layers of management! Myself and my staff worked our socks off and were constantly under pressure to do new projects and meet new targets while the other layers of management very conspicuously did very little but, of course, took all the credit. Eventually, on two occasions, my immediate managers got found out and were basically sacked, although both left with huge payouts. Neither were ever replaced and targets were still met. However, they both went on to other NHS jobs. One in particular has moved from job to job, usually not staying more than a year or two at each but climbing the ladder each time. She had absolutely no qualifications for the job she did (or didn’t do) when she was my manager and most certainly doesn’t have the qualifications for her later jobs. How did she manage it? Gift of the gab! Don’t NHS recruiters look at past performance? Obviously not!

Mollygo

Ann29

Wish we could sack MPs who are rotten apples.

I’ve often wished that there was a version of OFSTED for politicians.

We do have elections.

mae13

Some time ago, when I worked as a lab technician at a local hospital, a colleague idly pointed out to me one day "y'know, there's only two people in this department who haven't got the word 'Manager' on our name badges - me and you"

True enough. We were surrounded by onion-layers of clipboard wielding management types who spent an awful lot of time whizzing up and down the corridors attending (supposedly) "urgent meetings", while the non-manager minions were doing the donkey-work.

So there were actually quite a lot of non-manager donkeys?! Now I'm confused.