I’m an NHS manager

[Crunchyhobnob]

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

Why do you think that there is such a culture of bullying and blame within the NHS? Ex midwife here and it is most definitely endemic within any hospital/trust i've ever worked in. Part of the reason I quit.

What was your career path e.g what are your qualifications and experience and whats your rough salary- only trying to figure out how senior as there is senior in my job title also? But I am not senior in terms of NHS.

I work in the NHS as HCP always fascinated by the jobs that senior managers do as there is very rarely a face to the name.

@KitKat1985

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

In short no.

I assume you are talking about ward managers and matrons here, and I will assume you are talking about people with a professional registration, but correct me if I’m wrong.

Management and leadership are transferable skills, someone at that level should be able to pick up the practical skills, and learn the relevant clinical information quickly. What’s more important are their people skills, their leadership skills and their critical thinking skills.
What does frustrate me is the slow and general lack of progress there is available to nurses.

Following with interest, as a regional manager in the HSE (Irish Health Service) I'm always interested in the similarities/differences!

Someone earlier asked about non-clinical Mgmt for clinical areas and, just my two cents, I think they are for the best. Clinicians are not generally trained to manage and shouldn't be bogged down with all the admin and HR that goes along with it. Best practice to my mind is a clinical manager and admin/business manager working side by side with equal authority. Our clinicans need to be freed up to lead on clinical practice and development. And I say this as someone who would be considered a patient care professional by trade.

To OP, how do you assess where the NHS is as regards IT? It's an area the HSE is incredibly behind in and I can only imagine the efficiencies with a fully functioning IT infrastructure.

@wewillmeetagain

Why do you think that there is such a culture of bullying and blame within the NHS? Ex midwife here and it is most definitely endemic within any hospital/trust i've ever worked in. Part of the reason I quit.

This is a difficult topic and I am truly sorry you found this to be the case where you have worked. I know in the places I have worked there have been big drives to change the culture and to move away from blame, but I suppose it is human nature to try to find answers when something goes wrong, and it is very easy to fall into the mindset of needing to find the ‘person who did it’, especially when patients or their relatives are pushing for answers. As we know, when things do go wrong it is very rarely solely due to one person, and even more rare that the ‘thing’ was done deliberately. I hope one day everyone working for the benefit of patients will feel confident to speak up (and be listened to) if something isn’t right, as this is a powerful way to help prevent mistakes from happening in the first place.

Why do you guys not like doctors? Why do you smile at black doctors and once they turn around, roll your eyes at your fellow white colleague?

@LyraShaeLilly

What was your career path e.g what are your qualifications and experience and whats your rough salary- only trying to figure out how senior as there is senior in my job title also? But I am not senior in terms of NHS.

I work in the NHS as HCP always fascinated by the jobs that senior managers do as there is very rarely a face to the name.

I have an undergraduate degree and some postgraduate degrees too.

I started my career in the NHS as the equivalent of a band 2 (prior to agenda for change), but then I left to do one of my postgraduate qualifications full time at university and then I did the other one later whilst working (the NHS is good for providing support to go on relevant training courses, see one of my previous responses).

I am now an 8d

Why, in the 2020s is the NHS still so obsessed with writing letters to patients? No other comparable organisation does this, because it’s ridiculously slow, wasteful and expensive. Communication is almost entirely electronic, and consumers can choose how they prefer to be contacted. When is NHS communication going to move into the 21st century?

What kind of service do you manage?

I imagine as an 8D it's a multi-professional role?

Are you worried about the post-pandemic effect on mental health of your staff?

@TrixIrl

Following with interest, as a regional manager in the HSE (Irish Health Service) I'm always interested in the similarities/differences!

Someone earlier asked about non-clinical Mgmt for clinical areas and, just my two cents, I think they are for the best. Clinicians are not generally trained to manage and shouldn't be bogged down with all the admin and HR that goes along with it. Best practice to my mind is a clinical manager and admin/business manager working side by side with equal authority. Our clinicans need to be freed up to lead on clinical practice and development. And I say this as someone who would be considered a patient care professional by trade.

To OP, how do you assess where the NHS is as regards IT? It's an area the HSE is incredibly behind in and I can only imagine the efficiencies with a fully functioning IT infrastructure.

Thank you for your input, I completely agree with what you have said.

I am also interested in the similarities and differences between other health services.

With regards to IT... we’re getting there, BUT a lot of money has been wasted along the way. I do not understand why a team of software developers (and whoever else is needed) are not employed directly by the Department of Health to work with clinicians and managers to build the bespoke pieces of software we need for our unique and complex challenges. Why outsourcing this to companies who have no knowledge or understanding of how the health service and health economies all knit together has been the chosen path is beyond me.

@AgeLikeWine

Why, in the 2020s is the NHS still so obsessed with writing letters to patients? No other comparable organisation does this, because it’s ridiculously slow, wasteful and expensive. Communication is almost entirely electronic, and consumers can choose how they prefer to be contacted. When is NHS communication going to move into the 21st century?

This! Completely. Letters fir everything, to patients, to GPs (constantly). Loads and loads of admin time tied up audio typing. Why???

Are the Tories selling the NHS off but by bit with a view to moving to a private model?

@AgeLikeWine

Why, in the 2020s is the NHS still so obsessed with writing letters to patients? No other comparable organisation does this, because it’s ridiculously slow, wasteful and expensive. Communication is almost entirely electronic, and consumers can choose how they prefer to be contacted. When is NHS communication going to move into the 21st century?

Movement in the right direction is happening. Some Trusts now text patients their letters and others are moving to email... there is still an inherent distrust of email (which I don’t entirely understand as post is hardly a secure form of communication).

Most Trusts will now text you about your appointment (although usually just as a reminder), and many are looking at ways to enable patients to directly manage their appointments themselves via a website.

I hope it happens soon though, mainly from the perspective of being a potential patient and knowing how I would like to be communicated with!

Sadly it isn’t something I have direct control over.

Can you work from home at all, or is everything done "on site"?

What is your opinion on the power granted to procurement to "save the NHS budget"? Surely the NHS should be looking at the cost to treat - from diagnosis to being well versus the cost of devices?

So much tax payers money is being wasted by this focus on 8% of the NHS budget.

What's your opinion on this and how should the NHS move beyond its current practice?

Thats very impressive going from band 2 to 8d. One of the things I love about the NHS is that it is very easy to move through the ranks if your good at what you do and are willing to work hard.

@ProseccoThyme

What kind of service do you manage?

I imagine as an 8D it's a multi-professional role?

I manage clinical services but I am not a clinical manager, if that makes sense. I have managed a whole variety of different services and that is something I particularly enjoy about ‘general’ hospital management. my skills are transferable and I pick up the nuances of each individual service as I go along.

What do you mean by a multi professional role? Do you mean with regards to who I work with? If so then yes, I work with professionals across the whole multi professional team including doctors, nurses, and allied health professional.

AgeLikeWine I don't work in the NHS but I know some public sector organisations have reverted back to sending letters (or often a mix of letters and email/ SMS) because digital poverty is a far greater issue than many people realise - even those who do have email and readily tick that as a method of communication can be caught short if they run out of data or the screen on their phone gets cracked etc.

For some reason I can’t quote the next comment, but with regards to audio typing, many places are moving away from this now and moving to digital dictation or even using speech to text software.

Most letters are also emailed to GPs rather than sent (in fact there are targets related to that).

GPs are the gatekeepers to care, there must be one central place where all your medical records are stored together, and currently the responsibility to manage that record sits with your GP. therefore they must be updated after every episode of care you receive elsewhere. How else should this be communicated? Letters are sensible as they can be stored in your hospital record whilst an identical copy can go in your GP record.

@AyrshireAmbler49

Are the Tories selling the NHS off but by bit with a view to moving to a private model?

I hope not but sometimes I do worry about this.

Many areas of the NHS have always been ‘private’ (GP practices for example), but yes I understand your question and I don’t like to think too hard about it.

I am not in a position to change the direction the Tories are headed (except to not vote for them of course!)

@ArchbishopOfBanterbury

Can you work from home at all, or is everything done "on site"?

Yes some of my work can be done from home

Left the nhs after 35+ years not very long ago. Left on 8b. Registered professional.

I retired at the earliest opportunity ( took 2 weeks annual leave before my 55th birthday). Why? Sick to death of jumping through hoops ticking irrelevant boxes

The nhs has waaaay too many managers doing the same.

Hi how do you feel about all non-clinical staff working from home and still not being fully available to support clinical staff during COVID ie: suggesting that clinical staff take on various roles due to this lack of availability?

What are you doing to avert the inevitable mental health crisis that will engulf your clinical staff as a result of COVID?

How do you feel about insisting that all clinical staff suspend their A/L for January/February whilst maintaining that it is important that others within the Trust maintain good work life balance?

Thanks

@LyraShaeLilly

Thats very impressive going from band 2 to 8d. One of the things I love about the NHS is that it is very easy to move through the ranks if your good at what you do and are willing to work hard.

Thank you.

I am proud of where I began, and of the journey I have taken, and believe this shapes how I am as a manager.

I have worked hard but there is also an element of luck always.