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

This is just nonsense. At my hospital we have 500 consultants. They are all paid £100k+, and rightly so.
We employ 10,000 people overall. The HR team has one person in it earning £100k.

i think the majority of people who bang the too many mangers drum have zero idea how many managers there are and what they do

THE BIGGEST FAILINGS ARE WASTE AND INEFFICIENCY they cripple the NHS

as for pay the NHS pay is subjective people just quote the bottom line band of the pay scales where the reality is some roles they can earn between 25/30% on top of base pay by enhancements , 6 months sick pay generous holiday allowance and a hefty above average employer pension contributions

and not let’s forget people who take zero responsibility for there wellbeing

do tbh management is a blip rather than the cause of the downfall

Often, positions come into existence because of either a capacity shortage (which in what is definitely an undermanaged system is very real) or a skill deficit (which is unforgivable, but sadly inevitable in an organisation that over promotes career generalists without ever training them properly.)

What starts out as the cheapest, dirtiest workaround then grows legs of its own and becomes an expensive luxury that nobody has the wherewithal to actually get rid of even if they wanted to.

I agree. Over run with admin. And nurses on computers instead of taking care of patients.

In my experience (allied health professional) we could do with more admin staff for smooth running of clinics. I actually think there's more waste due to not enough admin. We haven't even got enough admin to have reception cover in lots of clinics. Leads to lots of problems. More admin please if anyone with sway is reading this!

I have a friend who is the lead consultant in a large hospital department. She’s always bitching about having to do the staffing rota. Why on earth are you doing this, when with your highly trained medical skills should surely be put to better use, I ask. Well there’s no one else to do it from outwith the department and she can’t delegate to a more junior staff member because the rotas, and who gets what time off is such a bone of contention no one else could really be asked to take that much grief / accusations of favouritism. Madness. Get more admin staff in!

There have been frequent reviews and independent reports that have all concluded that the NHS isn’t over managed.

That’s not to say that there aren’t instances of pointless roles or poor people working in NHS management. But anecdote doesn’t equal data.

We must also remember the nature what the NHS does. It’s healthcare delivery. Literally life and death. It is necessarily highly regulated. That regulation is inefficient and always will be. Quite a lot of the ‘pointless’ NHS management stuff really is pointless 99% of the time but has been deemed necessary because we need to keep tabs on everything, report on everything, keep people informed about everything, in case things go wrong.

I know. Of all the roles to go after in the NHS corporate world, a Comms officer on 35k seems a bizarre choice 😄

And how would a hospital attract good people to desk based roles if they're paying shit wages? You'd end up with an even more badly run and managed hospital as you'd either have low, skilled staff or not enough.

I'd also be interested in knowing which roles people think are unnecessary. I often see people say "I have no idea what these NHS managers do all day, get rid of them" but unless you know what they do, how do you know they're not necessary?

I'm a software testing manager in an NHS hospital. Do people on this thread know what my job entails? Do they think it's necessary and contributes to good patient care? Or would they get rid of me?

kinds fund - https://www.kingsfund.org.uk/insight-and-analysis/articles/big-election-questions-bureaucracy-nhs-2017#:~:text=However%2C%20there%20is%20no%20persuasive,they%20should%20not%20be%20denigrated. Other countries spend 50% more on health admin than us.

Warwick business school:

https://www.wbs.ac.uk/news/how-many-managers-does-the-uk-s-nhs-need/

IPPR, as reported by the BMJ. https://www.bmj.com/content/381/bmj.p1313

I could go on. There is no evidence I can find to the contrary. Does anyone have any fact based evidence to the contrary or is it just anecdotal?

I think the roles are often needed, but massively iverpaid. Any desk based job that involves attending meetings and sending emails should be 40k max, but HR staff etc are often paid almost as much as the doctors. The doctors shoukd be getting paid 3 x what any desk based office worker is paid, and nurses 2 x

My sister is a nurse, when she started her department had 11 nurses and two admin. Now it's 11 admin and two nurses who are rushed off their feet.

I am also helping someone with an NHS bullying employment tribunal. It has exposed to me that so much time is spent with petty squabbling between staff and departments, it's unbelievable.

The NHS is not short of staff (1.4 million) or money (£180Bn) but is short on best practice.

Did you not see this last week?

https://www.dw.com/en/british-pm-starmer-announces-nhs-england-to-be-abolished/a-71911413

Which roles do you feel are unecessary?

We've already had it suggeted that internal communications officers are unecessary. In an organisation of 1.5 million staff.

The NHS is an enormous organisation. Compared to other outfits of similar size it has too few managers, not too many.

However the quality of that management and the prioritisation of what it's spending time on is definitely worth investigating.

🙂 👍I don't know who Lansley was, I just remember my mum, who worked in NHS hospitals from late 70s to '99, remarking on the talk of the need to get shut of the extraneous pen pushers, this was sometime early to mid 90s.

Ah, yes, the NHS Confederation. For managers, run by managers!

Gawd, time goes by so fast! You're correct!

Absolutely. Cut the managerial nonsense and pay front line staff better.

Add another fifteen year to that twenty and you'll be closer.

I've been around the block in healthcare, both NHS and private, and I've long held the view that the Pareto Principle very much applies in NHS management: 20% of the people do 80% of the work. On that basis I'd be wary of tarring every NHS manager with the same brush but my god there is some dross in there.

One of my favourites was when I called the Public and Patient Engagement Lead at one of the then CCGs when I was working as a contractor. Before I'd even finished introducing myself she actually said "I don't do any doing." There we had it: I was being paid £750 a day to redesign a service and one of the requirements was for patient and public involvement in the redesign. I'd only wanted some advice about whether they had any preferred methodologies or existing participation groups, but the starting point of the woman whose actual job it was, was to refuse to do it.

yes - school are the same! Teaching staff get shafted and the trust IT or HR managers on 60k+

Multiple research papers all conclude that yhe nhs has far too few managers. See here for example:www.nhsconfed.org/long-reads/nhs-overmanaged