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.

@Almondflour exactly my experience too, I'm in a MH Trust and the neighbouring acute Trust pays a band higher for the exact same role (although those jobs never seem to come up unfortunately!)

That’s sad to hear. The system is too easy to play unfortunately. My experience from NHSE was that nearly all posts were artificially inflated. My boss even told me once that we would all be 2 bands lower if we were Trust-based.

Those and the one wanting to provoke yet another trans debate are just tedious

I assume from your previous dismissive and ignorant "culture war" replies that you are referring to me?

You posted an "AMA" thread as an NHS Manager. Then you reframe questions about legal responsibilities that have just cost another Trust over £600,000 as "culture wars", an attempt to "provoke yet another trans debate" and "tedious".

and I’m ignoring them.

Good to know that your post today at 07:07 was not an intemperate reply to me that you hastily asked Mumsnet to delete.

I agree with CrowsBuildingNests · Today 08:42

"This thread has perhaps revealed a great deal about the managerial mindset that we witnessed on the losing NHS Trusts’ sides (and also embedded in the Civil Service).

The gross waste of public money, the barely-veiled contempt shown toward the nurses, the ‘nothing to see here’ gambits, the strategic resignations, the lack of legal knowledge, the paucity of safeguarding training,"

I followed the Darlington Nurses case (and similar very costly NHS cases that have gone through the courts and others that are about to reach the courts) with a great deal of interest. Not least as an ex-NHS Manager with clinical responsibilities and considerably more management experience and training than you have mentioned that you have had.

Throughout the whole of the last NHS Trust where I worked, one of the largest in the UK, there was only one General Manager who had a management qualification at degree level, acquired after working as a Nurse Manager. The difference in expertise and performance compared to general managers with no clinical experience was . . . striking.

Rather than deriding your clinical colleagues as "blocking change" and "bitching" about general managers, some self-reflection might be in order.

I also ran courses for both NHS Managers and senior clinical staff. Should you ever be offered training that covers the issues I have raised in relation to legislation covering sex-based rights, I hope that you will pay attention and not waste your time arrogantly doodling "culture wars" and "tedious trans debate".

I'm a bit confused about why you think it's the OP's responsibility to check that Trusts she works with are compliant with various equality legislation? The CEO, COO, HR managers, DEI managers of those Trusts would be the people needing to ensure compliance, along with anyone who is making decisions about toilet or changing room provision. It's not something which is the responsibility of every single NHS maanger, just because they are an NHS manager.

I do understand why you might think that it is only the most senior managers, HR and DEI/EDI managers who would need to be aware of the legislation I mentioned and be responsible for compliance.

However, if you had watched what happened in recent Employment Tribunals and read the judgements then you would know that immediate, clinical line managers are also held responsible and are called to give evidence to explain their lack of compliance or, alternatively, their efforts to ensure compliance in the face of illegal NHS Trust policies.

These cases have generated huge public interest with over 1,000 people viewing proceedings remotely some days.

One headline takeaway would be that the very last people you can rely on to understand and comply with the law are HR Managers and DEI/EDI Managers.

Another would be that immediate, clinical line managers were much more likely to spot the flaws in illegal NHS Trust policies drawn up by HR and (very highly paid but woefully under-qualified) DEI/EDI managers.

Finally, I have never seen the CEO or the Chair being called to the witness box. As usual, Trusts ensure that the buck is passed down the line, not up.

I get that if people that I directly manage were being asked to share mixed sex changing rooms (wouldn't happen as we don't have changing rooms) or toilets, then I'd need to be checking legislation and potentially challenging whoever made the decision to implement the mixed sex toilets. But if there are mixed sex changing rooms or toilets introduced elsewhere in my Trust in a completely separate department to mine, which I have absolutely nothing to do with, have no remit for, zero influence on, and no management responsibility for anyone who works there, why on earth would you expect me to firstly be aware of it, and secondly to be held responsible in court for it? The OP works for NHSE, not the individual Trusts, why would she be responsible or accountable for ensuring that any Trust she spends time working with, complies with equality legislation?

It is here. Band 6 upwards need master level qualifications - specialist nurses or ward managers or sister or ANP all have master level qualification

My previous job was transformation lead in an acute trust. This job is different, with different pressures, but not less than working in a trust.
Re banding, most acutes have always down banded positions for the sake of cost cutting, whilst NHSE whilst not perfect and still expecting a lot out of the mid-bands, actually have JDs that mostly meet the AFC criteria.

Isn’t it masters or equivalent experience?

Yep. It’s irrelevant to me. I could take it up with trusts I suppose. But strangely they prefer my input to be about how I can help them make things better for patients. Strange that.

Still waffling on I see. Don’t knkw what you said. Haven’t bothered to read it.

Not at all. Most trusts are fiefdoms that like to exploit staff for as little money as they can get away with.

But EDI leads can seemingly command 9
over 80k a year - a pittance 😂

if there are mixed sex changing rooms or toilets introduced elsewhere in my Trust in a completely separate department to mine, which I have absolutely nothing to do with, have no remit for, zero influence on, and no management responsibility for anyone who works there, why on earth would you expect me to firstly be aware of it, and secondly to be held responsible in court for it?

No, I am not suggesting that you would need to be aware of what is happening in every individual dept in your Trust case-by-case and would be held responsible. I do not know what I have said that would give you that impression.

In the cases that have gone to court, the issues that have arisen in individual Depts have been due to Trust-wide policies. Maybe I said something about this that caused the misunderstanding?

The OP works for NHSE, not the individual Trusts, why would she be responsible or accountable for ensuring that any Trust she spends time working with, complies with equality legislation?

You are right. The OP would be responsible as a manager working for NHSE. Again, my apologies and thank you for the correction. I drifted into talking about NHS Trusts because the OP spoke about implementing change in clinical services and I forgot that she worked with Trusts rather than for Trusts.

The OP said, so she clearly understands the issues:

"It’s a tricky situation as we have such a strong EDI policy but that doesn’t protect women in these situations. It’s wrong, of course. I am all for understanding and equality for trans women but where does that leave us as biological women in vulnerable situations? I’m sorry, I don’t know the case and feel for the nurses, but have no suggestions and can’t provide an explanation of their decision. Speaking as a mother of two daughters though it angers me that they could be in that situation."

If the OP is a line manager then she might at some point find herself caught out by "a strong EDI policy" that requires her to choose between failing to comply with an illegal NHSE policy or breaking the law, ie. by unfairly discriminating against women on the basis of the Protected Characteristic of Sex.

Without sight of the "strong EDI policy" it is impossible to know whether the OP would find herself in such a compromised situation. However, NHSE was a member of the Stonewall Workplace Equality Index (I do not know if it still is) and funded the "Rainbow Badges" scheme, so it is likely that the "strong EDI policy" is based on a misrepresentation of the law.

If NHSE has reviewed and updated its EDI policies to reflect the Supreme Court judgement in the case of For Women Scotland v Scottish Ministers (16 April 2025) then she should be in the clear.

However, NHSE has yet to provide leadership by instructing recalcitrant NHS Trusts to comply with the law so I do not hold out much hope.

I assume you will not read this either.

So for the benefit of anyone reading this thread who does not work for the NHS: as an ex-NHS Manager, I would like to reassure you that not all NHS General Managers are so rude, arrogant and unwilling to listen.

I must say OP, from the tone of your replies and limited capacity to accept criticism or challenge… you are probably in the right job. (NHSE)

@Bosky
i second that . The OP comes across as extremely arrogant and big headed

I’m not a general manager. See did read it. Just not the lengthy ones about trans or whatever it was.

I do believe this is ama not berate me, bitch about me and criticise my employer. 💁🏻. Think it may be time to call this a day before I have to read any more vitriol.

Thanks OP. I do understand the necessity of plodding on. I did ten years as a senior officer in local government and quit when the cutbacks got to the point where it was no longer possible to offer the service we were expected to. My line manager told me that nobody expected me to meet my targets because it simply wasn’t possible with the resources available - but I was still getting the flak when those targets weren’t hit. It’s soul destroying.