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AMA

I’m an NHS manager

77 replies

Crunchyhobnob · 03/01/2021 02:16

Not the most popular people in the NHS! What do you want to know about NHS management?

OP posts:
vodkaredbullgirl · 03/01/2021 02:19
Hmm
umpteennamechanges · 03/01/2021 02:20

Why do you think there is a perception that NHS management cause inefficiencies?

Do you think it's accurate or unfair?

(Not NHS myself)

umpteennamechanges · 03/01/2021 02:21

Also what do you personally think about the capabilities of senior leadership in your specific area?

What is the working culture like where you are?

umpteennamechanges · 03/01/2021 02:22

And thirdly, why aren't you asleep? Night shift or insomnia?

vodkaredbullgirl · 03/01/2021 02:23

Managers never work nights, unless on call.

ProfessorSillyStuff · 03/01/2021 02:28

Thanks, such apt timing and I am very curious about this subject! I've never worked for the NHS, I'm just fascinated by social and legislative structures that affect everyone's wellbeing at such an intrinsic level.
I knew many different people who have worked across all kinds of NHS fields and practices. One common thread was the psychopathic behavior of bosses. I noticed this was also the case with those working for the council, where some of the roles also are care related, eg. Speech and language team.

Why do you think this happens in the public sector? Is it encouraged by senior management? Mandatory? Neccessary?

Do managers have these traits before assuming the role? Is it traits or just following orders? Thanks!

Crunchyhobnob · 03/01/2021 02:42

@umpteennamechanges

Why do you think there is a perception that NHS management cause inefficiencies?

Do you think it's accurate or unfair?

(Not NHS myself)

I think there is a general misunderstanding (across many sectors, not just the NHS) about what managers do. It’s easy to say that reducing the number of managers would improve efficiency, but it isn’t correct. Managers are there, in part, to help improve efficiencies in many areas and have the time to dedicate to doing this (unlike say doctors or nurses who, although may be involved in improvements, have other ‘main activities’ they are employed to do). It also depends on how you define a manager. Matrons are nurse managers, clinical directors are doctor managers. ‘General’ managers however manage every single admin function within their organisation. It’s all well and good saying that doctors and nurses should be running the hospitals, but they aren’t trained to do that, and many don’t have the skills nor the inclination to, that isn’t the field they went in to. Managers are generally there for the same reason though- the patients.

Sorry for my ramble, to sum up, I think the perception is unfair (there are always bad eggs that ruin it for the rest of us though!)

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umpteennamechanges · 03/01/2021 02:44

I've been a senior manager myself (non-NHS)...there seems to be a general perception though that the NHS is 'badly managed' and 'inefficient'.

Do you see evidence of this among your peers or not particularly?

Crunchyhobnob · 03/01/2021 02:44

@umpteennamechanges

Also what do you personally think about the capabilities of senior leadership in your specific area?

What is the working culture like where you are?

The senior leaders where I work are incredibly capable, they all have a wide range of experience and different backgrounds. I have worked in many organisations and all have different cultures. The culture can also change over time. The good thing about NHS management is that if the culture no longer suits you can go elsewhere and try something new.
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Crunchyhobnob · 03/01/2021 02:45

@umpteennamechanges

And thirdly, why aren't you asleep? Night shift or insomnia?
Small children!

I have been on call over the Christmas period though, thankfully I wasn’t woken up too many times.

OP posts:
Crunchyhobnob · 03/01/2021 02:49

@ProfessorSillyStuff

Thanks, such apt timing and I am very curious about this subject! I've never worked for the NHS, I'm just fascinated by social and legislative structures that affect everyone's wellbeing at such an intrinsic level. I knew many different people who have worked across all kinds of NHS fields and practices. One common thread was the psychopathic behavior of bosses. I noticed this was also the case with those working for the council, where some of the roles also are care related, eg. Speech and language team.

Why do you think this happens in the public sector? Is it encouraged by senior management? Mandatory? Neccessary?

Do managers have these traits before assuming the role? Is it traits or just following orders? Thanks!

I’m sorry to hear about your experiences of managers, and their psychopathic behaviour. You might need to elaborate on what you mean by that though I’m afraid as I can’t say that it is a trait I recognise amongst my colleagues.
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SusieBugandMe · 03/01/2021 02:53

Oh loads of questions from me:

Why do so many people get promoted to lower level management without any training in how to actually manage people?

What do you think about poor managers leaving one trust and just moving to another to perpetuate the same problems?

Do you think the level of management capabilities would stand up in the private sector?

SusieBugandMe · 03/01/2021 02:55

The trust I work in has born and bred NHS managers and managers who have come into the NHS from the private sector.

The differences are stark. Like black and white. I’m constantly amazed at the poor level of work, lack of initiative and frankly laziness of members of staff with performance management being virtually unheard of.

Crunchyhobnob · 03/01/2021 03:04

@umpteennamechanges

I've been a senior manager myself (non-NHS)...there seems to be a general perception though that the NHS is 'badly managed' and 'inefficient'.

Do you see evidence of this among your peers or not particularly?

My experience of the private sector isn’t extensive, so I have little to personally compare with, although speaking to colleagues with more experience the general consensus is that the perception is incorrect.

‘The NHS’ shouldn’t really be bulked all together into one thing, it is multiple organisations, and systems, all working together like massive cogs. Sometimes the cogs aren’t well oiled and are thus poorly run. This may be because of a lack of funding, and it’s incredibly difficult to run an organisation that has no money for innovation, it’s hard if you can’t ‘invest to save’. That isn’t to say that some organisations aren’t badly run, of course they are, but healthcare is incredibly complex and so there will always be areas of inefficiency.

The juggling act comes when you are trying to balance patient experience, and quality of care, with staying within incredibly tight budgets. Clinical staff (doctors, nurses, allied health professionals, etc) cost money, and they do take up the bulk of the budget. We are constantly having to reduce our admin budgets, but without administrators appointments can’t be booked, referrals can’t be sent, queries can’t be answered (etc) and so in come inefficiencies, as there aren’t enough people to make the processes streamlined and backlogs are created.

I think I’ve gone off tangent. What I’m trying to say is yes, there are inefficiencies and pockets of bad practice, but I don’t think that’s unique to the NHS, we just see people when they’re are their most vulnerable, and at those times even a small inefficiency can feel like a cavern.

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Crunchyhobnob · 03/01/2021 03:18

@SusieBugandMe

Oh loads of questions from me:

Why do so many people get promoted to lower level management without any training in how to actually manage people?

What do you think about poor managers leaving one trust and just moving to another to perpetuate the same problems?

Do you think the level of management capabilities would stand up in the private sector?

  1. good question, it is a frustration of mine too. Many organisations now do have in house programmes for people new to management and leadership. There are also NHS leadership academy courses which all organisations I have worked for will send people on (www.leadershipacademy.nhs.uk/programmes/)
  2. this is difficult and frustrating. I don’t think this is unique to the NHS, but yes we all know managers who are like this. I don’t have an answer on how to fix it unfortunately.
  3. Yes absolutely I do. (But maybe you should define the capabilities you perceive of managers in the private sector- do they have to tell someone that their life changing surgery has had to be cancelled as there aren’t enough beds? Have they had to write an action plan for how they are going to ensure the 12 month backlog of patients waiting for their procedures are all going to be seen within 6 months with no additional funding? Have they had to monitor the number of patients attending ED, knowing that it will be full any minute, trying to find additional staff from already short staffed wards to go and support patients being cared for in a corridor, as you can’t shut?- I think facing these challenges certainly gives you resilience and the ability to think on your feet... I assume the capabilities the private sector requires would depend on the nature of the business?)
OP posts:
coronafiona · 03/01/2021 04:02

What inefficiencies frustrate you and would you change?

Snog · 03/01/2021 23:18

Is there a macho bullying culture where you work?

Crunchyhobnob · 07/02/2021 21:32

Sorry, I didn’t get any updates until now.

No, I’m lucky, there definitely isn’t a macho bullying culture where I work. In fact I’ve never worked anywhere where I would describe it as macho. I’ve had some awful managers, but I’ve also had some amazing managers who have supported and developed me, kind of like I imagine you get in most large workplaces.

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lightand · 07/02/2021 21:44

How many people do you have above you, and how many below?

FlibbertyGiblets · 07/02/2021 22:03

What do you think about people like Katrina Percy, who leave a trail of dead patients in their wake as they move ever onwards?
(Might be deleted for posting this? Although it is true, she was in charge of Southern Health when an independent report showed that out of 722 unexpected deaths over four years, only 272 were properly investigated)

Crunchyhobnob · 07/02/2021 22:10

@lightand

How many people do you have above you, and how many below?
A couple
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Crunchyhobnob · 07/02/2021 22:12

Sorry, didn’t answer that fully

A couple above and quite a lot ‘below’ although obviously not all direct reports, people who report to the people who report to me.

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Crunchyhobnob · 07/02/2021 22:15

@FlibbertyGiblets

What do you think about people like Katrina Percy, who leave a trail of dead patients in their wake as they move ever onwards? (Might be deleted for posting this? Although it is true, she was in charge of Southern Health when an independent report showed that out of 722 unexpected deaths over four years, only 272 were properly investigated)
I believe we should continuously learn from the awful things that happen, I can’t comment properly on that case as I haven’t had a chance to read enough about it, except the headlines. From what I have read it is shocking that another job was just created for her though
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FlibbertyGiblets · 07/02/2021 22:18

Thank you for your swift reply. I agree with you.

This thread is so interesting, thank you.

KitKat1985 · 07/02/2021 22:21

Do you think it's inappropriate when managers are employed to manage clinical wards or areas they have no experience in?

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