To think the NHS Significant job losses are a good thing to get rid of management pushing paper around all day and increase the number of hands on staff

I thought (and still think) it is an interesting piece of info @Scenicgirl. Hope that helps.

Money will not be diverted to frontline/clinical roles. The NHS perse has a massive overspend and cuts are being made in an effort to reduce this - NHSE and all the NHS Integrated Care Boards (who fund and commission your local NHS services) are targeted to rightly avoid reducing clinical costs. The latter have to reduce costs by 50% by December. Having already reduced costs by 30% last year. There’s not much fat left trim and of course while implementing these cuts resources are diverted from delivering the work these organisations are meant to do (or staff expected to work the day job as well as managing the changes, redundancies etc). Am I worried. For me no - I can get another job. But for the future of the health service yes I am. I agree something radical needs to happen and I hope it works.

But do managers sit around “pushing paper” all day or do they, you know, manage stuff.

The NHS is a massive behemoth of an organisation. It needs managers.

I’m not saying efficiencies can’t be found but the characterisation of anyone who isn’t clinical staff as some kind of idle do-nothing pen-pusher is also grossly unfair.

Well, so what?
She was told in no uncertain terms that she wasn't suitable for the role so of course she should be paid to leave. The fact that she is returning to her old role means that they valued her. The majority of the people leaving will not be going on "huge packages".

The senior leaders in NHSE have in the vast majority already left, no doubt with huge financial packages. Amanda Pritchard is going back to her old job as Chief Exec of Guys and St Thomas's. She literally got paid over £200k to leave NHSE and have a holiday before starting her new (old) role!

YES! Exactly this!

I hear you!!

Govt: Lets make loads of changes to the NHS and tell patients and the public that they can have a say on this and be involved etc.
Also govt: Comms and engagement isn't really needed.
Patients and the public: What's going on in the NHS? How can I have my say? Why haven't you consulted us?
Govt: Woah, what's all this bad publicity. Why haven't Comms down something....?

I work in comms so we’re supposed to reduce numbers. We’re looking at changing services significantly but apparently comms isn’t important so I guess we will make changes and just not worry about explaining it to the public or consulting on it (key role of icb comms). We also do everything on a shoestring as we have historically always had the tiniest budgets compared to other corporate functions so I’m not sure we’re the team to find massive savings.

I did find a spend to save initiative that would cost less than £30k to implement but save £50k each year, likely more but that was all I could evidence. We can’t implement it due to team capacity. Just means we cannot modernise as we don’t have the people to do it.

I think trusts were told to cut the growth in corporate roles by 50%, which is slightly different.

NHS Trusts were instructed to implement a 50% cut to corporate functions such as HR, estates, non patient facing nurses.

Instead, NHS trusts seem to be freezing and scrutinising all vacancies, inc frontline clinical staff. This is being led by the people whose jobs should be the ones being let go.

The axe never swings up does it?

Job cuts at Addenbrookes and the Rosie in Cambridge.

Well I'm veering on the side of negativity as that's the reality.

Not always, but it's clear you are determined to be negative and not listen.

Veeeerrrry slooooowly

There's also lots of great work happening and good projects being completed.

There's no point having layers and layers of management between ICBs and NHSE and DoH etc if there's no money in the pot. They're all (ok most of them) redundant.

NHS ICB drones report to NHSE drones who report to Dept of Health drones
And if you work anywhere in this quagmire you know how slowly the wheels grind, and how often the slowly grinding wheels shudder to a halt in a cull de sac without reverse gear. And 1-2 years later the whole process starts again, IE the next 'pilot' .....

The NHS is one of the most undermanaged healthcare systems in the world. Arguably it possibly needs more management than less. Effective management leads to effective systems and services. Managers can’t be effective when they are under-resources, in the same way clinicians can’t. The axing managers narrative is popular with the public though, hence why it gets fed by politicians and the press.

The link that poster gave is about ICBs though, which is different to NHS England which is what the thread (started of as) about and different again to hospitals and hospital management which is what many people are now talking about. I'm also not sure people working in Comms, regulation, performance etc are what most people would describe as low banding or 'admin', not clinical maybe but then most people working in ICBs are not clinical. Most people that work in ICBs are in specialist corporate roles IME, Band 7+ and these will be the people most at risk of job loss in the next 6 months as this now seems to be where the quickest cuts are coming.

It's also my understanding that the rationale for cutting the functions you mention is in an attempt to reduce duplication between ICBs and provider/hospital trusts on the one hand and ICBs and NHSE on the other. I can sort of see the rationale for that, we do attend quite a lot of meetings with the ICB where we have to give a lot of updates and reports 'for assurance' with no real action taken (often the same or irritatingly close but not-quite-the-same as we have to do for NHSE), and I can see some duplication of effort on things like patient comms, very important of course but does it need to be done twice over or is that actually worse than doing it once and well? As a hospital manager I'm of course happy on a selfish level we seem to be a tiny bit more protected but being more cynical I'm not sure on what basis it's been decided it should be the ICB end that gets cut not the trusts, other than the fact it's not a good look politically to be cutting hospitals (well except they are cutting hospitals too but that's another thread). My other concern it that's it's fine to say we don't need 2 tiers of management in between trusts and the government but if we cut both NHSE and ICBs back totally, I'm not convinced chaos won't completely reign, plus I feel very sorry for my ICB colleagues who aren't to blame for the stupidity of the system around them...

ICBs are not generally what people are referring to when they talk about NHSE though, and you are then taking about NHS management as if they are the same, which is part of the problem on this thread. NHS and NHSE are separate. And NHSE regional and national teams do really important work holding ICBs and trusts to account.

Actually I work for an NHS ICB and can absolutely confirm there's a shed load of paper being pushed around and around , dozens of pointless recurring meetings that simply regurgitate the same verbal diahhrea every month , pointless admin tasks that will never result in anything useful. NHS management is a dinosaur and could be culled without any affect on patients.

I work in the charity sector and spent time working in the NHS managing income from trusts and foundations who fund research and treatment. It is a skilled job that carries stress due to the expectation and need for income.

Communciations roles in the NHS often ensure staff and patients are aware of vital information. This is also a skilled role.

The admin side of the NHS isn’t perfect by a long shot but neither is it people just mindlessly doing admin. It covers any number of skilled professional services.

Cutting assurance and regulation seems very short sighted! The ICBs already mark their own homework but now they don't even want that marking checked externally?

That's genuinely terrifying. Based on my experience working in NHSE until the end of last year, that will mean people will die as corners are cut by ICBs who don't always understand that the figures on their spreadsheets represent people receiving, or not receiving, healthcare.

Exactly. Since they cut secretarial support for consultants and outsourced typing letters the number of people turning up in the wrong clinic or on the wrong day, or missing appointments altogether has increased.
My consultant types her own letters while she is talking to me. She is always harassed and rushed. Getting the letter done is the most important thing. I know that nobody at the GP practice has time to read them anyway. She keeps asking them to put new painkillers on my repeat list and they always deny all knowledge.
I ended up in the wrong clinic for something recently due to clerical and admin errors. Such a waste of everybody's time and resources. It is the 3rd time it has happened to me and I am an experienced nurse. It is impossible to speak to anybody to check these things - you just have to turn up and try to sort it out while there.

In the hospital I work in, nothing would happen without the admin staff. The admin budget has already been cut to the bone and each time, services get worse. Sure, the computer and online systems could all be updated to work together and everything done electronically but it will be a massive and expensive and long undertaking and a lot of the clinical staff etc will point blank refuse to learn it, as they did with voice dictation software etc. They cry about doing any admin they do have so getting any more of it, meaning less time with patients etc will not go down well. The hospital can’t fill the vacancies they do have, so an ultimatum would result in them leaving and needing even more expensive locums to plug the gaps. Locums mainly refuse to do admin as well so the situation will get worse. Things run better with more admin staff, not less. If it means just cutting middle management, the work they do will be piled on lower pay grades which are already overstretched and underpaid for the responsibilities they have already.