Why do the NHS do this? Big waste of time and resources surely

[treatsortreating]

I've had a few unlucky times in the last year. And a few before that

Literally every time (I have 3 fairly local
Hospitals). They all do the same thing

Ward round, doctor says you can be discharged, you're good to go.

But you're waiting HOURS for a discharge letter? 8 hours on from being told I was okay to go home. Buzzed nurse again. This time someone else as hand over had been done. 'Oh yes you can go, but we're just waiting on your discharge letter'

I don't understand it? I really don't.

Why don't they post it? It can be done. My DC has a serious issue with something and a very good yet a bit further away hospital always see her. I take her to them as they're great (Addenbrooke's, Cambridge)

They never discharge her and then make us wait for discharge papers. Those get posted. Simple.

Surely this method of making people wait for discharge letters is taking up beds? Someone could've had my bed over 8 hours ago and still I was waiting

I was still unwell so couldn't put up much of a protest but it just seems an insane waste of time

It was actually OK. TV wasn't blaring at all & it was nice big comfy seats. Plenty space to wander about

They'll never please anyone but it's a far more effective way of getting beds available for incoming patients

I did wonder about this. Every other company has administrative staff and managers to help it run smoothly. I know the NHS is a massive organisation but surely that means even more reason to make sure the medics time is spent doing medical things?

Well you would think so, but there’s a weirdly large body of public opinion that thinks money should only be spent on Drs and Nurses and that any money spent on management and admin is a waste. The trouble is that the NHS is under-managed and therefore badly managed, which creates waste.

A discharge letter is written by a clinician
As already said upthread

Managers just manage the clinicians ie sod all
Admin is clerical and ward clerk and secretarial - helpful

Oh god yes, we're screwed when our ward clerk is off. Makes so many things take longer. And for my outpatients, my secretary is worth her weight in diamond studded platinum. I'm sure some of the managers must be doing something useful...

Haha oh yes the managers are busy composing E mails to try to get us to do things differently and you know complete mandatory training, or you know do extra shifts
Strange. We used to be able to manage ourselves .. 😜

As managers seem not to be wanted or needed in end NHS I guess I'd best find another job. I am a manager, I manage a team of people in the IT department. I also manage upgrades to our various clinical systems and our PAS, which introduce new features that clinical staff have asked for, and fix bugs they've reported.

But it seems best if I quit and let my team of band 4s and 5s manage themselves. They can also manage the upgrades, write the safety case, lead the hazard review meeting with the Trust's clinical safety officers, liaise with the chief clinical information officers to agree the contents of each release, and be responsible and accountable for anything that goes wrong, because there won't be any managers above them to do that. As well as managing the upgrades and everything else, they can do their usual jobs of writing and reviewing user stories, and writing and running the tests, writing documentation so the clinical and admin staff know what's new in each release. But they won't get any support to do this, if they're unsure of something or need to make an important decision they won't have anyone to ask, or check with.

No you've misunderstood - you are doing an actual job. But in HR we have managers whose job it is to just tell us to work a bit more

@RichardMarxisinnocent Well said. People are mainly clueless about NHS management, and bleat populist nonsense. Management has been a target for every government in at least 40 years. It's a load of old bullshit that they do nothing. I will say that in my day, the then NHS executive nationally allowed its managers to create conflicting initiatives, so that poor managers in hospitals were running around delivering conflicting things. That isn't a local problem, though, and it's due to ignorance of the BHS on the ground by those at the top. Nearly every NHS manager I met had too much on.

I’m a community HCP and a physical copy of the DC is quite frequently an absolute godsend. My cohort of patients are usually frail with multiple long term conditions and polypharmacy. Many of them have dementia. If I’m asked to see a patient urgently who was DC the day before and are now unwell again (increasingly common due to bed pressure to discharge) I need to see:
Their diagnosis/diagnoses
Their treatment whilst in hospital
The meds they were DC with (and what meds have been stopped).

Without all of these I’m working in the dark.

The electronic DC summary is forwarded to the GP but often takes time (sometimes days) to be uploaded.

A great example of why a paper copy is so important is for patients who have been DC on a prednisolone tapering regime and have not been told/do not understand what a prednisolone tapering regime is. It’s all there in the DC letter though and makes life for relatives, carers, community/primary care HCPs a thousand times easier to support the patient with.

Managers who are structuring services at upper levels fair enough though most of the power has been taken from the clinicians apart from the ,ones who sidestep into Mx or CDs but the HR rota coordinators are doing a job we did before on our spare time - except now they have the power to eg to decline our leave . And there's so much crap middle management it's unbelievable. If the bed pressures were sorted the bed managers wouldn't be needed.

@lovecrazyhorses agreed.