To say the NHS does not have too many admin staff?

[Leakingtoilet]

www.telegraph.co.uk/news/2022/12/30/nhs-has-many-admin-staff-not-enough-managers/

We don't have enough staff to get the job done, hence the fact we are constantly offering admin and secretarial overtime. It seems that way in most other departments that I have dealings with. Plus it's really difficult to recruit to vacant posts.

Anyone have a different experience?

It's very easy to say flippantly there are too much or too little of certain staff, without looking at root cause of the issues.

Someone in another thread said that appointments were all sent out by letter, meaning loads of people missing surgery and "wasting " NHS time because they didn't know they were meant to be there.

It feels like they need external people to go in and really analyse the problems and come up with solutions that are realistic to instigate.

It's not that kind of admin. Midwives and nurses can't outsource that kind of admin, no one else can sign to say they've referred to a dr or given a medication etc,
Our PIN is worth too much. If something happened it wouldn't stand up in court

I think this thread is about admin staff who send letters and fill appointments etc, which we need more of!

About 54% of NHS staff are professionally & medically qualified, then add in porters and other non pro trained but patient facing roles.....

For my DD she could not do her job without a team of admin staff in the discharge team..... all worked off their feet and on just above NMW.

However, i don't understand the internal market stuff... and the privatisation of so much that should be NHS, wheelchairs and other mobility aids all private sector, all charge a fucking bomb to clean and supply.

How much is all this costing the NHS in additional staff and private profit?

My DH is in a similar role and your post absolutely chimes with his experience of the same.
Managers get demonised (or indeed all non-clinical staff) but the reality is they're needed so that clinical staff aren't spending even more time doing admin, and are badly needed in terms of the large scale projects required to update the technology and improve efficiency. I can't read the article as it's behind a paywall but I don't think pitting managers against admin is the answer. Efficiency of process is required but that takes people to deliver it. And properly remunerating and attracting permanent staff to fill some of the many recruitment gaps rather than the counter-productive spending on temporary staff at vastly higher day rates.

In my team we are generally understaffed at grass roots level which is due to staff retention and recruitment. I do agree there seem to be too many in management level although can't comment on what they actually do.

I really can't understand why there is still so much paperwork in the NHS. I have dodgy eyes so have been under the Opthamology team since I was 4, I have this huge thick file that is dragged out every 6 months to circulate through the hospital, being dropped on a desk then transferred to another desk then taken into a test room and dropped on another desk. On testing day when I have to have a whole host of different eye exams and stick my head in a bazillion different machines all in different rooms culminating in a 2 min chat with the consultant, I spend more time waiting for my file to catch up with me so they can do the test than I do actually doing the tests.

Why isn't it all electronic now?

I know it can be because when I was in for my gallbladder via A&E they were updating on the computer and using phone apps.

Then there's the somewhat ridiculous letter in triplicate that's put in my hospital file, sent to me by post and sent to my GP by post who put it in a pile and finally get round to scanning it and adding it to my GP record a month later which I can access via an app on my phone. Why can this not just be added to my NHS record by the hospital and my GP receive a notification of a new entry?

Any BA/process analyst would have a meltdown trying to get past the complete lack of efficiency.

actually my own team is adequately staffed
it is the other team next door that are sitting on their laurels,

that is surprising @FatAgainItsLettuceTime
we are all electronic - as you can be
the letters to GP are electronic,
your notes are electronic
all been for some years.

One of my friends is a consultant surgeon. He used to have a dedicated secretary who knew his ways of working, understood the speciality, was dedicated etc made sure everything worked well. Due to cost savings, they changed the model to have a lower grade admin bank of staff. Since the change it’s been a shit show. No-one is accountable for a particular area, could be one of a large number of pool staff doing his letters so less
relationship, letters are missed as are appointments. He reckons it’s cost much more in wasted appointment time than the staff costs would have ever saved for a much worse service. Sometimes spending money on ‘admin’ is the efficient and better quality way to do things.

Exactly this. The NHS "needs" it's current level of admin staff because the processes are inefficient and cumbersome. The systems need radical reform. If there's one organisation that needs the old "time and motion" studies, it's the NHS. I have no doubt at all that the vast majority of staff are busy and hard working! But a hell of a lot of what they do could be streamlined, systemised, etc. into more efficient processes. It's still harking from the old ages where it was easier/cheaper just to employ more staff rather than actually tackling the cumbersome working practices.

although i dont really know how the GPs work their electronic systems
do they print off the letters and scan onto notes
or just scan onto notes?

Having been in coal face roles and in senior roles - it's really easy in a patient facing coal face role to assume everyone else does absolutely nothing of worth and swans around having their best life.

However, I found the wholly clinical roles had the advantage of being at least limited by a shift pattern whereas senior roles were almost a 24 hour commitment.

Admin is essential. I run 8 clinics a week as a band 7 specialist that's approximately 50 appointments all of which need booking, and then often changing due to illness, patients holiday, haircut( yes really) . Sec does all letters and emails to gp, copy to patient by mail as emails not secure or wanted as most pts over 70. She answers patients queries, chases GPS for medication requests, ensures referrals are done . If I did all this it would take me away form my patients at least 50% of the time. I dread her being on leave ! Not all 7/8 manage teams / depts alot are specialists in there field covering care drs don't have time for .

If the whole system was more efficient, there would be no need for many of the admin or managerial staff. This is the biggest issue facing the NHS. Without better organisation it will just get worse as money is being wasted on excess admin. Modern IT systems could revolutionise patient care if more was invested into it.

WAYYY too many managers/matrons and not enough ‘staff on the ground’ IME as NHS staff. Not necessarily effective management either.

It's a very old-fashioned organisation and there has never been any incentive for them to modernise, they get the money anyway and going fully digital would mean less jobs.

totally agree
and far less job satisfaction for anyone

who made this decision.
unfair for all,
unfair for the lower bands who are assumed to be capable of taking on the typing and unfair on the original staff who are now left with over seeing and no job satisfaction.
but it wont go back.

Every process I have seen as a daily visitor to an inpatient for last couple of months is inefficient despite stressed staff trying.

My kids and I have outpatient appointments across 3 hospitals and most take over 3 months to type/send clinic letter with actions/blood forms. Appointments are still sent by post, often arriving after the clinic date.

Contrast that with my experience in European countries where the blood form or prescription is issued at the appointment directly onto a central system so you can go to any pharmacy in the country to collect with no paper involved and it is instant. It is so different it is unbelievable. We dont need to invent a new computer systems just copy some of these systems .

Some 15 years ago I briefly worked in NHS IT. There was a big push then to get all the systems to join up. The problem was, and is, that hospitals and GPs all used different systems which wouldn't speak to each other. And nobody wanted to switch to anything new because of the huge disruption that would cause.

I imagine that nothing much has changed. (That big push, "NPfIT" for anyone who remembers it, collapsed completely for assorted reasons.)

I think to go fully paperless the NHS would need huge investment. It is way behind technology wise.

I have been through Trust merger and even between 2 local Trusts the difference in paperwork used is huge. So national is unthinkable.

i think covid has helped
where i work we now routinely have
electronic x ray requests, electronic blood requests, electronic prescription requests for a start.
many hospitals are now only taking referrals via email and rejecting the paper referral letter

slowly but surely

But just being "electronic" doesn't mean efficiency. I've worked on computerising manual systems for decades (fair enough not NHS) mostly in accounting, stock control, costing, etc in small/medium organisations.

I've seen (and solved) some absolute howlers of "computerisation" where tens/hundreds of thousands of pounds was spent on "bespoke" specially written programs "because the organisation was complicated and couldn't possibly use off the shelf software". What the computer bods did was computerise a chaotic mess because the organisation were adament they were "so special" and unique! So, the end result was inefficient computerisation, sometimes it worked, most often it didn't and led to even more admin staff. Time and time again, we'd just scrap it and make them change their internal workings so that an off the shelf package would work!

The "best" was an oil rig electrical component firm. They had a convoluted stock numbering system that was a chaotic mix of numbers, letters, symbols and degrees - each product code was (from memory) 19 characters long. But then their design/drawing office also had their own numbering system which was completely different but similar - i.e. a mix of letters, numbers, symbols, degrees, etc but in a different order. It was so chaotic that they had their own internal department called "planning" where a dozen or so office bods made sense of it all by matching part numbers to drawings manually. The firm was growing rapidly and the whole admin was getting out of control. They had a "beauty parade" of IT firms who came in to review the processes and offer their solution. Quotes of millions were received for a company wide bespoke software solution. I was employed by their auditors, and we were asked for our opinions on their proposals and whether we had alternative solutions. Our team came up with our "solution" - it was an off the shelf system (Pegasus) that we knew well as we worked with it at other manufacturing clients - cost was £30k, we had only one criteria to make it work which was that drawing and parts numbers had to be changed into a coherent code - cue horrified stares from the board of directors, but when we explained how it worked elsewhere, they started to look interested. A year later, the implementation was complete, and it worked. The "planning" dept was redeployed temporarily to change the coding/numbering system which was a big task and took several months, and to keep control of it during the changeover period. After the successful implementation, the "planning" team were re-assigned over other departments to help liaison between departments. It was a whopping success at a fraction of the cost of the "bespoke" solutions which may not even have worked.

I'm in the middle here. I believe the NHS does have ridiculous amounts of admin staff but it's not the workers fault, it's the poor IT systems. Last time I was in a hospital I was in a waiting room while my daughter got an x-ray and I was watching the sheer volume of paper being moved between files by the staff at the reception desk thinking what a huge amount of wasted resources there was.

However, I think it's pretty clear that these paper shuffling roles are needed because the management and leadership simply haven't invested in the technology that could take much of this away, so the staff are clearly needed. There are hugely complex international corporations with thousands of staff yet with fractions of the admin roles needed, simply because they have the systems in place to remove the need for paper being moved from one file to another, or one department to another.

However, there are some clearly archaic processes in the NHS that would save significant time. My daughter got her x-ray and then proceeded to wait an hour while the x-ray images were burnt onto a CD that she then had to take with her to her dentist. I mean, come on - this is ridiculous both in terms of time, effort and resources to simply get some images to my daughter/ her dentist - they're only digital images and email exists.

So no, the NHS isn't overstaffed with admin people for the systems and processes they have in place, but those systems and processes need a huge overhaul.

Too many commissioners despite the recent moving the deckchairs / calling them something else charade.