I’m an NHS manager

[secretnhsmanager]

I know you all hate me and think I’m a flabby, bloated bureaucrat or whatever our Secretary of State is calling us this week. I work for the dreaded NHS England, you know, the one about to be abolished. I’m in one of the regional teams and I’m a fairly senior manager working in an area of medicine that is something that involves lots of different hospital departments - it’s a condition that requires an emergency ambulance so think cardiac.

I work alongside clinicians in the services to identify where they can improve their services for patients and then help them to do that. It’s a lovely, rewarding job and I find that the clinicians I work with are appreciative of what we do.

We don’t get an opportunity to tell the public what we do and in the media we are always criticised and assumptions made about us that just aren’t true. What’s really depressing is that a lot of clinical staff hold the same opinions of us. So here I am. Ask me anything.

oh and btw our collective opinion of Wes is that he’s a total wanker.

I remember a training video in my Trust said something about a hospital being more akin to a town in terms of structural complexity, and I think it’s this idea that lots of people don’t appreciate fully.

I’m top of the 8D pay scale so just over £100k.
re trans issues, it’s really not a thing. We have a strong EDI policy that covers, well all EDI, but the nhs obsession with trans is just a media thing

Thank you and thank your husband. Sadly he’s right.

Just acknowledging how shit it is. ICB worker here and we still don't know our structure. VRs been and gone. It's a mess. Like others so disheartening.
Love so much of my role (still lucky to have a direct line of sight to patient care) but those with no idea see you as a pen pusher. Like the NHS would only run with clinicians..... it's like saying a school only needs teachers.... who's going to clean the bogs and answer the phones

I’m a B3 non-clinical role. Due to recent tightenings of the purse strings it’s taken me two months to get a simple replacement battery for my laptop authorised, yet I am also aware of Consultants coming to interview for us, and claiming expenses that include train tickets and a takeaway Starbucks. The PSM wasn’t happy but authorised them anyway. How do you feel about where the taxpayers money is actually going?

I don’t have medical training and I earn slightly less than most consultants. The NHS is a complex set of organisations that employ a few million staff across the nhs family. We can’t exist just to provide front door treatment to patients. We need the back office staff to allow that to happen, indeed to even employ the clinical staff. As we luckily live in a works where there are constant healthcare innovations, new treat,wants, new diagnostics etc we need people who have the skills to implement these improvements and do it so there are no interruptions to patient care, just the improvements. That’s what I do and what my surprisingly small tea, does.

Yes, definitely.

I hear you 😘

@secretnhsmanager you keep mentioning the importance of EDI. If EDI is so important, why isn't there better regard for women's pain relief and why have there been so many maternity scandals where families have been lied to?

Also, why is it that in my local outpatient departments men are called intontheor appointments as Mr John Smith and women as Jane Smith. Notwithstanding the fact that most doctors think I should afford them the respect and courtesy of their title whilst assuming they may use my first name. Why are patients and/or women regarded as subordinates.

Do you realise that if I referred to my employer as a wanker, I'd be swiftly dismissed?

Why does the NHS think it can keep patients waiting for 90 minutes for an appointment whilst having a zero tolerance approach to a patient being five minutes late. Ditto wgen appointments are cancelled at short notice with little or no apology? Shouldn't respect be mutual?

Why does the NHS not deal with capability? A friend of mine is leaving NHS England, because she is so sick of carrying incompetent colleagues who are repeatedly sick, late or not delivering because management more senior than her grade 8 say they can't do anything due to protected characteristics. In the real world, following the correct procedures, these things can be dealt with. Why not in the NHS?

Thanks for your reply. I trained at St Thomas’ in London, when hospitals were run by matrons and consultants, with few managers. It was super efficient. No wastage. It was a great time. If only life was still like that…

Very angry. Most consultants are fab, but there are always those who think that they are god and they are the ones who are holding back the NHS because they do not understand or are willing to accept change. However it feeds into the public perceptions of the things we do as being pointless ams the things clinicians do as being wonderful. It doesn’t help the nhs at all.

Those days are very much over. The NHS is too big for that structure to work now and besides, consultants and matrons are not good managers so I highly doubt thst those hospitals would even ge safe places for patients these days.

No hate here OP.
Ex NHS manager here too.
it’s a bloody hard job and most people have no idea of what goes on behind the scenes.
I’m glad I’m an ex NHS manager now.

You are talking about several separate issues. EDI protects women in this workplace, makes sure that we are not at a disadvantage when we have children and that people of any race, sex, with disabilities etc are not discrimated against in the workplace. Do you not agree with that?

women being treated as second class citizens in medicine and the patriarchal attitudes towards things like period pain, childbirth amd so on is a separate issue and one I’m not qualified to discuss in depth because I have never worked in gynae or obstetrics. As a woman who has given birth to two children I am angry that male obstetricians treated me as an incubator and my very real fears weee dismissed as insignificant.

im on an anonymous forum and so I am in a safe place to call the sos for health a Wanker. If I said it in a joint briefing between NHSE and DHSC then I’d expect rapped knuckles. On here, I have the freedom to call a wanker a wanker.

I agree about keeping patients waiting and lack of respect for patients lives and times. So can’t argue with that or offer a defence.

your friend though,…hmm in the 20:years I’ve been doing this I’ve never come across a case of sickness that wasn’t genuine and so I’m thinking it’s a bit of hyperbole in either their part…or yours.

Do you or other senior managers see what happens on the wards in person? Do you recognise the picture of nurses chatting behind the desk while patients are trying to sleep, elderly patients trying to leave their beds unsupervised by staff who are sat scrolling on tiktok, ancillary depts like phlebotomy being basically closed all day because the staff shut the door or go in the break room, phones ringing unanswered by people sat doing nothing? Or do those sorts of reports seem exaggerated?

😘

I’m an ICU nurse who was very briefly non clinical (pregnant and deemed not safe to work clinically at the very start of covid), I was redeployed to managing PPE stocks and medication shortish for our ICU which was by then triple its maximum capacity, a role im entirely unqualified for I may add but hey it was all hands on deck! And I must say I sat in meetings with the NHS managers and it really gave me a huge insight into what managers actually do, it was hugely stressful! I admit as a clinician I did have the attitude of “tell them to get a pair of gloves on if they want to help!”, and I now have a lot of respect for what yous do, to run a hospital people are needed behind the scenes. Of course I don’t share this in the tea room as I would be shot.

Yes I do, I quote,often visit wards where nurses are apparently sat at a desk or chatting or on the computer doing nothing. In all cases they are doing something…the chatting is about a patient or other work related topic, the computer is admin or looking up,eg nice guidance or something.
wards are busy places 24/7 ams so there is going to be disturbances. This is unfortunate for patients who’s re trying to sleep, but no hospital staff will do this on purpose.
that said, of course there are incidences of bad practice and I’m sorry for patients who experience them. It is not professional ans not representative of the majority of staff. Please report it where it’s seen because these things are dealt with - patients may not be aware, but in previous jobs when I’ve been based in hospitals I’ve had lots of quiet chats about behaviour. I do think also that some patients have the view that nursing staff are some kind of personal servamt for them and that they should,respond to every whim even if the nurse is doing CPR in an cubicle next door.

Thank,you for what you do. I cannot imagine the stress of your job ams certainly couldn’t do it. I spent covid in a hospital knowing that I was sending my staff into horrendous situations that could damage them physically and mentally and I a, haunted by that even now. I did put the gloves on and went onto the ward (respiratory) and helped some patients have contact with their families through FaceTime. Some also on ITU where the fa,ily we’re saying goodbye. Those experiences haunt us all. But I was able to return to my own world whilst for you and your colleagues it is your everyday.

As a social care worker in an NHS setting, the "bed blocking' (don't use that word as it dehumanises people) is misunderstood.
Some time ago the NHS brought a number of beds in nursing homes for people to be discharged to. Then they cut the number in half so people are waiting weeks for them. The NHS and government say we're not allowed to discharge anywhere else unless it's long term. The block comes from the NHS not social care! (In my area).

Thanks for answering. I'm sure some patients are horrendous too, people on either side can show bad sides to themselves. Fwiw i've been on numerous wards and you can normally hear every word, so its pretty clear when someone's chatting or on fb while your syringe driver is bleeping for a straight hour. It's genuinely good to hear there is more good practice than bad - my experience is that paeds is impeccable, and geriatrics basically like purgatory, with gynae somewhere in between but closer to hell, but i'm sure others will see it differently

As a manager on nearly £100k, how do you separate the fact that women are not afforded equality of access to pain relief or are adressed with less respect than men from general sex discrimination as defined by The Equality Act (2010). Sex discrimination implies that women are treated less favourably than men - whether as workers or patients, it matters not a jot.

So, you'd only get rapped on the knuckles with NHS England for saying Wes was a wanker. In the real world that would result in a first and final warning or dismissal.

I'm sorry male obstetricians treated you badly. In my experience the male (and female) obstetricians were far more repectful and considerate than the midwives.

My friend's experience is entirely genuine although obviously I'm not going to publicly note her specialism, name or location. She is, howevet, sick of doing a huge workload whilst those around her, same grade, do bugger all.

I realise times have changed, it’s very sad. Our training was amazing and we had fun. The junior doctors slept on the ward and we all helped each other. We had IRA terrorists as patients. We had the first AIDS patient diagnosed in the UK. We had the fastest crash call response n Europe. We worked night and day and striking was not even discussed. How I wish young nurses and doctors could experience what we did. We got free bus transport- everyone loved a Tommys nurse. We got free West End Tickets. We partied at the Cafe Royale. We had breakfast after night shifts at The Dorchester. It was fabulous. Now everyone is fed up, determined to strike for more pay, and the public seem to have lost respect for the NHS. We truly cared about our jobs and going to work was not a tedious endurance. I worked 60 night shifts in a row to earn some decent money - it didn’t phase me at all. As a newly qualified nurse you found yourself running a night shift. Often you didn’t get a break. But there was always a good supply of chocolates. It set you up for life, being resilient.

What's your salary and do you think it is justified, compared to clinical staff?

It’s a totally different job. My responsibilities span across a region of over 5 million people. My salary is justified in terms of what I do. Clinicians do a completely different job.