To think the NHS is bloated with unnecessary management while frontline staff - doctors and nurses - are overworked and overpaid?

Do you work in the NHS? Can you expand on this point?

Really because who is going to coordinate our outpatient waiting lists? I’m a med sec and I’m damned sure I don’t have the time to do this in my working week.

I haven’t read the whole thread yet but really wanted to offer perspective on this. I am a boots on the ground NHS admin-med sec.

The wrongly booked appointments-our systems don’t always link up (in our trust there are currently 5 that I use on a regular basis that don’t talk to each other, 2 for imaging, 1 for outpatients appointments, 1 for inpatient stuff and 1 for physio…..none of these systems cross over into the other).

The glaring spelling errors, we do our best, and I am pretty good with spelling and grammar but some of my colleagues are not so good. We currently have 300 odd letters waiting to be typed in our service alone, on top of all the other work we have to do and with probably 300-400 or so patients being seen each week in clinic this number never goes down (there are 5 med secs in our team). We are just trying to bash them out as fast as we can.

The entirely different medical condition-we just type what our consultants dictate…we do not have the time to check each one to make sure that the diagnosis dictated is correct.

The admin staff are as overwhelmed with work as the clinical staff, and most of the time we are just trying to keep our heads above water.

I think technology is a big issue.

When I was pregnant, I was assessed as high risk.

I filled in my original answers on Badger notes. Then was asked them again at the initial midwife appointment. She put me on the high risk pathway, and gave me the Blue Book. The blue book did not include the right appointments for my pathway.

Some appointments appeared in Badger Notes. Some appointments were sent by letter. Some were booked in person and did not appear either by letter or app. Ditto for test results.

I occasionally left my blue book behind because it seemed to have no function except for illegible scrawling. I was berated for this - what if I fainted and nobody knew I was pregnant? They might root through my bag for medical info, obviously.

At 37 weeks, my blue book had disintegrated and I was given a new one.

38:5 - emergency admission for preeclampsia. I read the new blue book and noticed for the first time it has an additional screening quiz to the previous, showing that I more than meet the threshold for preventative aspirin.

The factors for preventative aspirin are there in the first fucking set of screening questions? It would be the simplest thing in the world to build this in to the programme.

i agree @Lickityspit

There is sooo much crap spoken about the NHS , and so often by those with plans behind the scenes, or some idiot who says their sister in law saw it in her part time job (probably not a very connected one).

I’d love you to expand on this and explain your reasoning, because I can’t believe that some who works for the NHS actually has so little understanding of how it works.
Please come back and tell us more!

I was talking about the council with sick pay.

The firing procedure is the same as the private sector but it's rarely carried through hence why there's do much dead wood.

This - our local Diversity something or other (can't remember his precise job title), was lovely, getting out and about, building links with hard to reach communities.

People seem to get triggered by the word 'Diversity', but it's about removing barriers to services so people can access them - which is surely a good thing!

one admits it fully. He likens it to our benefits system. Whereby it isn’t his fault, he’s just playing the game. The others think they are important, one way more so - obviously all from a mere outsiders interpretation.

But I do think they are paid far too much in comparison to the people on the ground doing the more valuable and needed work.

This. So much of the NHs is an inefficient process and unwillingness / inability to modernise.

and also the tenders govt agencies get for building systems are always so garbage.

Yep I think these are precisely the kind of pointless jobs that people are referring to. I saw a role for an inclusivity manager paying 70k!! The job description was vague as you would expect and this is what people are angry about. Of course there needs to be a lot of administrative roles in the NHS but these made up/pointless jobs that only exist to fill some kind of quota need to go.

Full sick pay from day one? nope, can take 5 years before the 6month full pay kicks in.

Or do you think a nurse who contracts Covid or another illness during her work should be on SSP and then sacked after 2 weeks? Maybe you do.

The processes and employment law for firing poorly performing staff is exactly the same in a private company as it is in the NHS....

I 100% agree as someone who has worked in the NHS for 25 years, internal markets caused so many problems for us.

You keep repeating this without actually giving anything solid that you’ve based on your opinion on. Just the hur dur too many managers.

Just on that point big companies do have DEI teams. I worked for one with c30,000 employees who had about 8 in the Inclusion team.

Exactly this. In fact there is no single company in the UK that is the equivalent of the entire NHS. Shell has 100k employees, NHS has over 1.4m. Shell CEO is paid around £8m.
Honestly I wouldn't be the CEO of a trust if you paid me double their salary. Yes it's different because it's public sector and the pension is good, but I don't think VampVamp and others have actually thought what it means to be accountable officer for a trust.
And by the way VapeVamp the fact that NHS have project managers even though your company supplied project managers, I can confidently tell you that it's because your company PM does not do all the things that need doing. How do you think your invoices get paid? PM has to raise a PQ, confirm the work was done as per contract and then raise the PO and get the invoice paid. Who does all the risk management and governance which again is required of public sector as we can be FOId on this stuff? Who does the benefits tracking? It can't be left to the supplier as the trust would end up in the daily mail criticised for being hands off !

our letters are posted, there is no discussion around emailing letters, however our contacts are made very much by email.

In our trust we still have paper because an extremely vocal minority of our patient groups are tin foil hat nut jobs who refuse to support any move to digital systems because they refuse for their data to be handled electronically.

And if you think NHS management is expensive, you’ve never seen how bad clinical staff can be a managers, or how much time they waste on administration when it could be done by cheaper admin staff, who actually understand administration. This is not helped by the extremely snobbish attitude of some of my colleagues towards non-clinical staff.

nope not in the area i work in but they dont even quote an email address in their letters.

I agree and it's the same in councils; difficult to fire anyone/full sick pay from day one (which leads to so many lost days with some staff taking the piss) and so much dead wood.

I think the big problem in the NHS is an ageing population, costing way more to keep alive than could possibly be afforded.

But you do you…

Or perhaps their client group is overwhelmingly elderly and prefers real post? And perhaps it’s required for audit and information governance purposes?

Well, first off, it was you who compared them when you talked about NHS wages relative to engineering consultancy wages.

It seems to be a common tactic amongst the NHS Manager-sceptic community to make a point, have it debunked, and then say that’s not the point.

But regardless, your new argument seems to be that it’s OK for a profit making company to employ a top manager on £1m+, but you begrudge the same role in an NHS trust of the same size being paid one tenth as much? Even though the person concerned would be in charge of healing the sick, dealing with people in the last stages of life and the first of untold grief, bringing babies into the world, and spending £1bn of public money as wisely as possible?

It’s a bold take, I’ll give you that.

it is shocking to me that some large london hospitals post their letters, do not have emails addresses quoted in the letters, perhaps too big and unwieldly to manage