NHS employee- workload doubled overnight

[Hurryupretirement]

I am posting this as I think it’s important that people know how the government is ‘tackling’ NHS waiting lists.

I am an NHS nurse with 28 years experience. I work in a specialized area which assesses people for a specific, life limiting condition. The assessment process is long and detailed.

We, like most of the NHS, have a waiting list ( we lost 9 months over covid and haven’t been able to recover).

With no notice whatsoever we were told that we would need to see double the number of patients. We had to make it work. Non negotiable.

Myself and my colleagues are now working evenings and weekends just to stay afloat.

This is the NHS’s ‘plan’ for tackling waiting lists.

I’m sorry to read your post OP. Sadly this is now all too common in the NHS.

I am also a senior clinician with 30 years of experience. I too was working in a specialised role assessing and managing complex patients in the community.

I burnt out in June which manifested as severe anxiety and depression. I resigned and am still not working. I have come to a realisation that I will likely never return to working in the NHS again. My health is too important to return to a job that causes me harm.

The combined pressures of increasing work loads, constant monitoring and criticism from non-patient facing managers (all under the guise of patient safety but in reality aggressive arse covering by management needing to shift blame for mistakes made due to over work), ever increasing expectations of documentation, regular abuse by patients and relatives and bullying by other members of staff was all too much for me. I was a zombie going to work, I ended up not giving a shit about anything.

Many counselling sessions later I’ve realised that my job mirrored many aspects of living in an abusive relationship.

I’d start considering your exit plan now before you burn out. Good luck to you.

Sadly I bet this is happening all over the NHS, a way of fudging the stats. Defo speak to Union, this cannot be allowed to happen. Remember to keep your boundaries, no extra hours unless you are being paid and you want to work the extra. Defo agree with other posters and get EVERYTHING in writing. If it isn't currently in writing email your managers and say you need it in writing. Don't be afraid to kick up a storm. I work in the NHS and would be fighting this, its not worth your registration nor risking your health or that of patients.

Still affected by COVID? This is a management failure to recruit and staff properly and the answer isn't to pile more work on.

Do you have a union? Are you all united in this?

Do you have an MP?

An experienced qualified nurse must surely be in demand in the private sector. What stops you considering your own quality of life and moving on?

You can be 2 of these things, never 3:

Cheap
Quick
Good

Pick your choice.

💐You have my sympathy OP.

I am also NHS (but non clinical) and our department is chronically understaffed.
This due to covering for people who are off long term sick or for people who just leave because of the woking conditions.
Its a vicious cycle of consistently covering for others, breaking the remaining staff in the process, which leads to long term sickness....

I know 2 people who are signed off due to work related stress from the NHS at the moment both receiving full pay as under six months. It makes no sense to burn people out this way, patient care is more of a marathon than a sprint.

But what I’ve described above isn’t possible- I can’t help but compare it to my own assignment at the moment (which is also public sector) where people claim they are doing 2/3 peoples jobs - and practically they are absolutely not doing 2 peoples jobs, and yes, mainly because it sounds unlikely and therefore is unlikely.

how, in practical terms, can you see double patients if you were at capacity before? even the weekend, for example (which of course you shouldn’t be working) is only a 40% increase in capacity, far from 100% claimed.

They’re dealing with patients with a life limiting condition therefore treatment approaches need to be holistic and will require a multidisciplinary approach inc physio, OT, and end of life care planning (I expect), amongst other things. Cutting the time could mean a reduced quality of life for patients. Imagine receiving a diagnosis like that and then being rushed through an appointment like you don’t matter. It’s awful.

Get the union involved. Immediately.

I’m ex-NHS HR. In between the first and second lockdowns, one of the heads of service set up a 7 days a week service for her area, promising staff they would get TOIL for their weekend working. Which was great in terms of patient wait times, but when it transpired that each member of staff was building up between 1 and 2 weeks of TOIL each month, and had already accrued months worth of hours we had to consider paying it instead. It was over £1m worth, which was completely unaffordable. The head of service was (rightly) sacked.

It’s all good for people to make these promises, but they very rarely think think through the impact on the people who actually do the work. 😡

I’m really concerned about this Government’s approach. The waiting list delays are mainly due to lock downs and junior doctor strikes, it’s not due to staff inefficiency yet the blame seems to be being put on the NHS. They will lose more staff, more will go off sick with stress and burn out, it’s not sustainable. This isn’t the answer. Meanwhile care agencies will be closing due to higher NI payments meaning more patients are stuck in hospital awaiting social care. It’s not looking good.

You are NHS. Start a dignity at work complaint and use events process you can. Manger who pull this crap only get away with it because the staff are silent.

I work in a specialised area of the NHS. We have targets from NHS England that are unmanageable at present due to lack of staff and other work.

You need management support. If your line manager and their manager are not supportive keep going up. Ask for a meeting with senior staff to discus (we have done this as a team in the past). Have they done a demand and capacity review (which looks at what work you do).

My main advice is do not work unpaid. A couple of nurses in my team do/ have done this and they are the ones who are the most stressed. They cannot make you work over your hours. Keep the work to the standard required but do what you can do in your hours. Put everything on Outlook (I have 'admin time' for example and then inside the outlook appointment put every phone call (and how long it took), letter, and everything else in.

www.england.nhs.uk/ourwork/freedom-to-speak-up/

This is also worth looking up.

Yes agree with pp. find out who your Trust's FTSU champion is. Contact them and cite concern for patient safety.

But they can't see twice as many patients, that's the point. Or they try to, and each patient only recieves half the amount of time. Which can be very harmful, and worse than nothing. They don't get a proper work up because there isn't time, which means the advice is wrong or useless. And then they don't get access to a proper service because they've "been seen".

I would really hate to work for your sector. This attitude is everything that's wrong with the currentvsystem.My bet is that your poor clinical staff ARE seeing two clinician's load of patients, and the quality (and therefore patients and clinicians) is suffering because of it.

Talk to your union.

Ime a lot of this half baked thinking comes from strategic managers who have no clinical experience making directional decisions. These guys go from one management job to another, whether healthcare, food production, whatever, it all looks the same to them and they cause harm because they aren't aware of operational considerations. Eg the manager who thought that the way to prioritise waiting lists was to bump up people who were of working age, because delaying treatment would have a more deleterious effect than delaying treatment for retired people. No understanding whatsoever of ethics, the domino effect of poor elderly health, of ageism FFS! They just pull these ideas out of a fucking hat I swear to god and you have to confront them. But via a union obviously.

er yes, they can.

enough people left our department, so.. they closed it. Simple as that.

especially if you are a specialist department dealing with a specific expertise. You don’t bring in the big budget, or, for example, you are preventative so save money, which doesn’t show in the income column.

Then your specialist work is outsourced, to another, less experienced but slightly related department, either in your trust, outside it, or commissioned from a private service.

My what? Did you mean to reply to me? I don’t have any clinical roles or patients!

Seeing people outside of medical locations sounds insane.

The conveyor system requires extra space to prepare the next patient for interaction. So without that you're a bit stuck unless space can be divided.

It is possible.... or there abouts.

Take my department. 6 employees.
Currently have 2 vacancies, 1 on sick leave but expected back for mid January.

Gess what, Christmas holidays are cancelled exept for one person (= claimed rightly childcare issues)
That leaves 2 people to do the work of 6 people for the 2 weeks Christmas break.

They can see double patients by cutting the service they offer, that's the problem. If they're told to fit twice as many in, the appointments will be shorter, rushed, not as detailed or tailored to the individual, and ultimately, probably much less use.

I had an experience with nhs physio, nothing major or life changing like this might well be, but painful and difficult to live with nonetheless. The individual physio service was changed - in one instance, I had a telephone call and a leaflet instead. That physio got through way more than double the previous number of patients. In the other instance, we were offered a group Pilates class, where the instructor wasn't allowed to touch anyone, just sort of watch them and offer suggestions. There were six in the class, so they got through three times as many patients in the space that would normally have seen maybe two. It was totally useless, and in the end, I had to pay for a private session and then just struggle on alone. But the targets probably looked like they'd been met.

It's not physically possible to double the capacity of an identical service, if they weren't under capacity before or allowed to work overtime, but I fully expect that what they are being told to do will be to cut corners and not offer what they had been offering before, which would be detrimental to both patients and staff morale.

I wish taxes had been raised slightly for everyone, and then more services could be funded properly, rather than trying to fudge the data and waiting lists like this.

Your first sentence sums it up.
We are being told to reduce the time taken for assessment of the patient, we gather less information and have significantly less time to focus on the patients emotional needs. Then there is the worry that in reducing the time spent on each assessment we risk making a wrong diagnosis and as I mentioned we are talking about a life changing/ limiting diagnosis.

We have senior management (band 8 for anyone au fait with the NHS) sitting in our clinical meetings telling us how to be more efficient, the atmosphere of scrutiny feels hostile and makes me feel physically ill.

This happened to me in intermediate care and I left.

It was shit.

I asked where we were supposed to find the extra time from and never got an answer. I said it wasn't safe.

I'm sorry but this is the way other organisations had to catch up after COVID.

Would any of us find it acceptable if our insurance company, bank, hairdresser told us they were behind producing documents. Would be a ten week wait for an appointment etc? I know these are flimsy examples in comparison but you have to catch up before you can keep up.