To think large proportions of the population do not understand how consultant job plans work?

Most corporate employers do not allow people to work additional hours and particularly in a job where there is a conflict of interest.

8 patients a week for a full time role? How do you know this? With best wishes from a slightly aggrieved and definitely overworked clinical psychologist 🥲

Professional Activities

Not my experience. Out of the 20 or so consultants I worked with for years there was 1 who was an absolute nightmare, 2-3 who were hit or miss and the rest worked their butts off. Some to an absolute extreme. Only 5 ever did private on top of their NHS work.

Admin sessions exist theoretically but more often than not they are lost to extra clinical work with people doing admin in their own time.
I do agree there is so much inefficiency in the NHS and most of the consultants are just as frustrated by those inefficiencies as the rest of us - if not more so.

Im a retired consultant who worked 10 PAs . My salary was never anywhere near £120,000. I worked 9 till 6 or 7 most days. I did no private work . I regularly had no breaks and didn’t get lunch. Not all my time was spent with patients. I had to supervise medical students and trainees. I had to attend management and mdt meetings . I had to check results and do admin. It could take 2 hours after a clinic finished to write up notes and dictate letters to GPs.
Reading journals, preparing for appraisal, writing up complex cases all happened at home. No chance of having enough time to do that at work even though I was supposed to have time allocated for it.
Either you work in an unusual setting op, or you have a chip on your shoulder/ want to stir up feelings against hospital consultants.

Most people working with consultants think the consultant only does the bits they see. They have no clue that the consultant is still working till 7 or 8 pm in the evenings and most of the weekend when they are at home. Also that they are not allowed to do any private work during their contracted NHS hours.
One of the biggest waste of everybody's time is the utterly shameful NHS IT systems and the appalling design of new buildings and facilities. Examination rooms with only one electric socket, printers that never work, no paper because it is rationed, it is endless.

@cunningartificer GPs are partners or employees. If the partners will not employ more GPs, who will make them? No one.

Im sure consultants are not lazy - many have 2 jobs.

Bollocks. I’m paid 11PAs. My diarying consistently proves I work 13 PAs. I’ve never done any private work. Oh, and most of us aren’t surgeons.

And whilst being slagged off as lazy by idiots. It must be demoralised.

This really isn’t the quick issue and solution you seem to say. It’s frustrating when people not actually doing a job assume that they know what people who are doing it are doing with their time. You actually have no idea about research admin etc that individuals may have done unless you are on intimate terms with a lot of people you seem to dislike who simultaneously are sharing every detail of their contracts and working day with you.

You clearly feel that some consultants are lazy, and perhaps you have met some who are, but I’m not convinced by your evidence that this is something you can extrapolate to the whole of the NHS, as I know many consultants and the last thing they are is lazy—often they’re supporting and teaching as well as working on their own careers. I know a couple of retirees who went back during Covid and they were absolutely heroic in what they did. I don’t generalise and say all consultants are heroic, and I’m wary of someone doing the opposite.

Yes you will always get some people who aren’t great in every profession but this is like saying all teachers leave work at 3 PM and don’t do anything in their long holidays….

If you want to talk about inefficiency in the NHS how about the lack of GPs when we have an oversupply of trained GPs but no posts for them, or the huge cost of trusts using locums long term to fill jobs rather than funding posts that would be cheaper instead, the equivalent of using permanent supply teachers rather than recruiting good people who want jobs.

Very interesting post and I learned a lot. Some frankly stupid responses here.

Why would anyone not care about our NHS?

It affects us all.

I am under the care of five separate consultants and the service I get is extremely variable from excellent to one who is bewilderingly disorganised and doesn’t seem bothered about his patients at all.

I am one of those patients you mention who arrived for a procedure which could not go ahead because this consultant had not checked it’s suitability to my specific needs.

A complete waste of my time and nhs resources and some other poor patient who could have used my slot missed out.

The disorganised consultant is your stereotypical superior middle aged bloke with a minor god complex and the efficient others are all down to earth normal approachable people.

You have described my dh's working life to a tee! Hes supposedly on a 10 PA contract but working at least 12! 1 PA to do admin in theory would mean 3 hours a week to do his admin - he doesn't get it! All admin is done on his own time! Ward rounds are not just all over the hospital, its worse than that, it's over 2 bloody hospitals! 🤦‍♀️ All his clinics are overbooked, all his Endoscopy lists are overbooked. He has zero control over the bookings. Hes working himself into an early grave 🙁 oh and he's seeing a counsellor for anxiety, insomnia and burnout, all whilst still working many more hours than he is paid for.

OP you definitely do not describe the average Consultant's working week!

A consultant on 10PA who wants to do private work must first offer an 11th PA to the Trust they work for which the Trust can chose to take up or not.

Sorry this is your experience but it's not mine.. emails get answered out of hours, on annual leave etc. Admin sessions are a theoretical concept but emergencies and urgent cases and over flow clinics mop them up. Consultants very stressed. Of course they need admin time. How else do they read results, write letters, research difficult cases etc.
I honestly don't see what you describe in my sector. However....I can imagine in less acute specialities you will get some slack.

This, exactly.

the consultants can do whatever they flipping want on their days off (which is of course when they're doing their private work).

We pay alot of money for people to manage this in our health systems. So, no, we don't understand it like you won't understand how other professions operate.

When I worked in the NHS, any private clinicians I met were astounded at how hard NHS staff actually worked. That’s always been said.

This thread is plainly politically or commercially motivated, and not at all about NHS doctors in reality.

I do 10 PAs and I don't earn 120k. I do at least 4 clinics every week and the state of the system with so few kids being supported by inadequate services, means that I spend at least 4 hours following the clinic just doing admin generated from thar clinic. That means dictating a letter using a dictate system that I need to correct afterwards because they have cut admin staff to the quick and making multiple referrals on multiple systems all of which require me to enter the patient details multiple times and all of which have impossible passwords. That is before I even start triaging and the huge amount of phone messages and results I need to respond to. I am in the hospital every day, 5 days a week, as I am there to supervise juniors. If I'm not (i.e at a conference) I'm directly available (on my personal mobile as I'm not given a work one). My SPA time is inevitably sucked up into admin and extra clinics because I run behind in my follow ups (too few staff, too many referrals) and kids hit crisis point before their follow up comes up and I need to bring them in earlier. Oh and because I'm now several months behind on follow ups, every child I see has got into a right state and needs even more of a sort out, which means more admin and more referrals.

I spend the first day of every annual leave on catch up. Most consultants I know are really busy. I make the job work around my family but that means I'm often finishing admin at the end of the day. I really think the days of consultants disappearing off to the golf course or to private practice are behind us!

Yes, the MDTs are very important and time consuming.

It’s allowing GPs and consultants to work part time. They want to do this because they have huge pension pots that will be taxed so they drop hours. They also then allow private working with no cost to the private provider.

This. The part time working thing really is a problem, it means the NHS bears the full cost burden of training up doctors only for the private sector to cream off the most profitable areas.

I work in a private company, and my contract has language in that essentially blocks me from taking on another job without agreeing it with my line management. I understand why - if i spread myself too thin, I'm not going to do as good a job for them.

I don't understand why we allow a consultant on a full time contract to do another 12-16 hours a week elsewhere. Let the bloody private sector train its own resource.

Like in any job there will be people who don't pull their weight.
My dh worked between 60 and 80 hours a week for 30 years. The NHS is a very challenging workplace where the goal posts are constantly shifted by people who have no idea what the consequences of cost cutting and poor management will be.
For example:
Management announce they want a ward round done by a consultant every morning at 08.00 hrs. But they closed the specialist wards, so 20 patients are spread in general wards all over a huge hospital. It takes hours. Then they complain the consultant is late for the clinic that is scheduled for 3 mornings a week. So they want to move the clinics. Then they complain that the afternoon teaching sessions are delayed.
Then they announce that every consultant must do a business case to justify how many support staff are needed to run clinics, including out patient procedures. Arguing about the cost of a part time nurse to run one clinic goes on for weeks, in meetings that disrupt everybody's schedule.
The next thing is that now everyone has email, 3 consultants must share one secretary, deal with all their own correspondence and type their own clinic letters.
In between all of this there are clinical governance meetings, interviews, incident reviews, clinical audits, research, as well as being on call 24/7 every 4th week.
The number of hours that a consultant can be paid for is strictly controlled and salaried. An awful lot of work is done outside of salaried hours late at night and over weekends.
I am sorry that OP has only met lazy consultants.
My experience has been a huge workload that can, at times, be overwhelming.

I get paid for 11PAs/week ie 44 hours.

I’ve worked 50+ hours already this week and I’ve got more work to do. None of that is SPA. By Monday am I’ll have done 55 hours minimum. This is a typical week, no crisis etc.

Yes, there are some who don’t do enough but very many who work very hard indeed.

Please ignore the twatty people op. Your post was incredibly interesting. Makes a lot of sense why nhs care can be so variable, and quite depressing really!

OP you present the work as seeing patients only 3 days out of 7. What are you on about? Do you work 7 days a week? Does anyone? So you’re biased, for a starter. I couldn’t then believe this was a post in good faith.

I followed the explanation but, in essence, your gripe is that to you some seem inefficient. Not a word of praise for those who work hours and hours on top? Oh dear, some leave the tedious appraisal stuff till the last minute.