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

With the repetition of meaningless soundbites and inability to answer a direct question, I'm starting to think this is a bot/ChatGPT.

Not NHS but get emails all day with communication stuff and award nominations and do this competition and celebrate this and join this meeting

I’m in a call centre, we don’t have time to read the email let alone nominate someone for something so all the lower paid staff get left out of this kind of stuff unless we do it in our own time. What actually happens is they carry on with the meetings and awards etc and none of us get involved

I think some admins just create work for themselves tbh. The amount of times I've emailed asking 2 or 3 clearly laid out questions and they answer one and ignore the rest so theres more back and forth.

I had about ten emails back and forth with an NHS admin a few years ago asking for copies of my x-rays so that I could show them to my physio. She kept refusing to send them and when I pressed on "'why" I eventually got the response of "its just not usual thats all, but here you go". Ten flipping emails when they could have done it first time.

A typical NHS trust has perhaps 10,000 staff. The only non-medical managers paid six figures would be the Board of Directors (maybe 7 people?) and perhaps the leaders of large corporate teams like Finance and Digital. Maybe another half dozen people. So max 15 out of 10,000. None will be paid anywhere near the private sector equivalent for leading an organisation of that size and complexity and turnover (because very few such private sector businesses actually exist.

So there aren’t ’so many’ on six figure salaries. And I’d argue that we very much need at least the few we have.

Out of interest, how much do you think the Director of Finance, say, at a £1bn turnover business with 10,000 employees should earn? Bear in mind that a FTSE250 DF would probably be earning £1m+.

So you'd like a discussion about whether the NHS has unnecessary managment roles without discussing any managment roles?

Or is it that you actually don't know anything about the NHS's structure or its non-clinical roles and so can't give specifics?

Is this true though? Do hardworking tax payers really not want NHS buildings that are safe? Do they not want NHS staff to be appropriately qualified and trained? Do they not want processes in place and monitored to make sure that medicines are handled properly? Do they not want doctors paid on time?
That’s what managers do! Amongst many other very valuable things that, were they to not happen, people would quite rightly be furious about.

My DH is a university lecturer. His eyes roll so far back in his head at this guff that he could look straight down the back of his kecks. He'd prefer students to attend lectures and seminars, listen and pay attention rather than chatting and twatting on phones, and hand in legible work on time - their own work, that is. Regardless of what side they've decided to dress on that morning, or whether they're Ryan or Rihanna, or whatever.

It was clear what you meant by the context -that won't stop some pendants here nitpicking, though.

I totally agree with you, it's a complete travesty and not at all where people would want their hard-earned tax contributions to go.

I’ve never been employed by the NHS so can’t comment with any real knowledgeability. However, I have many years experience of working in the public sector elsewhere and suspect similar trends apply.

IME a lot of management roles exist to try to overcome processes that are no longer fit for purpose. Rather than redesign the process (which is admittedly challenging), they just pay people to deal with the problems resulting from it. And they only deal with half of it. The rest of the fallout is left to the frontline to manage rather than allowing them to actually get on with patient care.

This is why wholesale reform is needed. There are vast inefficiencies in the NHS that even I can see (an insider must see even more). But there are egos and politics involved in NHS Trusts and ICBs which prevent this. It needs a long-term (20-year +) agreed cross-party approach to really achieve improvement.

I’ve worked in a senior admin role in the NHS for 20 years and stand very firmly by the principle that you do need admin and management roles. Do you want your doctors and nurses dealing with complaints processes/governance/meeting management or actually get them to triage and treat?
The problem with the NHS is that it is very very slow to adopt new technology, and it’s almost impossible to get rid of terrible people.

As I said, can you explain which roles you feel are unnecessary? Specifics.

It’s not about how the salary of a desk based job in the NHS compares to a doctor’s salary. It’s about how it compares to similar desk based jobs outside of the NHS. Why would you want to do a desk based role role in the NHS and earn say £35k when you can go do a similar one elsewhere and get paid £60k for it? So all the people with the right skills for it go elsewhere

On computers? Doing admin you mean?!

Also, many (not all) admin staff … we’ve had the misfortune on both mine and DHs side of the family to have lots of relatives needing care and hospital time/appointments over the last few years.
The number of incorrectly booked appointments and discharge letters with glaring spelling errors and in a few cases, an entirely different medical condition discussed is highly alarming. Lord knows the errors they make that we can’t see.

Well you have asked that question; and have been told provided with numerous links to academic studies which show that the NHS is under managed. I’m sorry if that evidence disappoints you.

The NHS’s many problems are not caused by manager numbers or structures. They’re caused by an ageing population, increased expectations which can’t be met, over-diagnosis and over medicalisation of some MH conditions, shortage of clinical staff, and poor facilities. Management structure comes way below any of those things.

I’m calling bullshit on this. How big is this ‘large’ team? I presume your trust employs thousands of people so I’d be interested in how you know that ‘practically all’ of them immediately delete emails.

And you seem to forget that the work of NHS diversity teams isn’t really about staff. It’s about patients - making sure that services are welcoming and suitable to everyone.

100% agree. Just one example but it always makes me laugh. When the covid vaccine was first rolled out and given to HCW there was some left over in the hospital. The hospital were given permission to vaccinate some of the most high risk inpatients should the patient wish to have it. Cue 3 (three!!) qualified healthcare workers (now in non clinical managerial roles) come to the ward, along with hospital PR person and photographer to make a big deal of this moment. Oh, turns out not one of them knows how to use the (now 3 year old) electronic health record because it's too complicated to use and they haven't bothered to learn. So seek out the help of staff nurse who is already run ragged with 12 patients in her care and not a minute to spare... to help the 3 of them do the mandatory checks, consent, administration and documentation of the vaccine. All while they smile for the camera🙃 And then swan off to coffee like the most important people in the universe. Please tell me how any of this is seen as ok.

I sympathise, and thank you for your work.

But the problem isn’t too many managers. Frankly it’s too many patients. And too few nurses. Cutting managers wouldn’t solve either problem, and would create new problems.

The only solutions are to reduce patient expectations (ie for the NHS to do less) and for nursing to be made a more attractive career option through such things as higher salary, uni fees paid for etc. All long term solutions. If we sacked all the managers today there’d still be too few people wanting to become nurses to actually mean more nurses to help you.

The trust I work for has a large ‘inclusion and diversity’ dept.
I can’t tell you the joy the very frequent emails about gender, advertising meetings re. trans, non binary etc etc bring when I’m living on my last nerve with a huge caseload of complex patients.
They get instantly deleted by practically all my colleagues. We don’t even have time to read them.

I’m a nurse in the nhs.

I’ve never suffered anxiety before. But I can’t sleep before my shifts now with severe anxiety, I feel sick going to work. I finish a shift and can’t sleep with worry. We are always short staffed or outnumbered by inexperienced staff which makes for a dangerous ward. My colleagues are having panic attacks, at least two nurses cry on shift every shift, we are trying to look out for each other.

i want to leave nursing.

not sure what the answer is. Our management team just keep saying “we’ve got you the numbers” but half of our staff have less than a years experience which in a skilled Itu setting isn’t good enough but the experienced nurses are leaving left right and centre

50,000 managers would mean that 97% of NHS staff aren’t managers. Seems reasonable.

If a doctor gets paid 100k, how much should a desk based role be paid then? I would say less than 50%, the same skill and hard work isn't required, and if it can be done from home people are often not doing much