Page 3 | To say the NHS does not have too many admin staff?

Leakingtoilet · 2022-12-31T10:10:27+00:00

https://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?

Florenz · 31/12/2022 12:04

Someone on another thread reported getting a letter with the wrong address on for an appointment, which means that people are actually manually typing the letters instead of them being auto-generated, there's no other way the wrong address could be on there if the appointment was actually somewhere else. It's a ludicrously outdated and inefficient organisation and someone private needs to be brought in to modernise it, even if it pisses off the existing staff (which it will, because a lot of their jobs will disappear).

Willmafrockfit · 31/12/2022 12:07

not in every trust @Florenz
many are far more up to date

GPTec1 · 31/12/2022 12:16

Florenz · 31/12/2022 11:44

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.

Its the Govt that has not provided the money for a decent, modern network, the NHS in itself cannot do this.

I don't think people have a clue what they are talking about when they say the NHS needs to go "digital"

You'd need 10s of billions, accept major disruption, provide access to 70 million patient records, provide infrastructure into all GP and private practice surgeries, provide full and robust redundancy for ALL systems and link all the hospitals, trusts, MH services... the lot.

Plus by the time they'd even got round to drawing up the roll out, the kit would be heading for out of support & by going for the very latest stuff, you become unpaid R&D for the s/w and hardware.
People have no idea of the timescales for a project of this size.

All at a time when there are 7.2m waiting for treatment, staff shortages, strikes, low morale and pay.

There isn't 10 billion for a pay rise, where is many times this amount going to appear from?

Esp as @Florenz is against tax and pay rises.

antipodeancanary · 31/12/2022 12:17

I'm a band 8, so paid quite a lot as far as the NHS goes. I have no admin support whatsoever. I do my own scanning, typing, photocopying, make my own patient resources. I make my own stationery orders, chase up missing PPE, contact the courier myself when things go missing. I phone and make my own patient appointments and send out confirmation letters. I take and type up minutes. I spend at least half of my time doing admin tasks that someone paid one third as much as me could do in half the time and better. I have no particular clerical skills. I used to have a clerk, but she was disappeared as a cost saving measure. Surely anyone can see how ridiculous this is.

Willmafrockfit · 31/12/2022 12:19

exactly @antipodeancanary
and so many clinical staff, consultants, are having to do so much of their own admin now.
and badly - when a far lower band could be usefully employed - some manager made this decision

user1497207191 · 31/12/2022 12:19

Yep, I know someone who works in the local hospital whose job is literally to type data read from one screen onto the other screen. She has 2 computers, one with system A and the other with system B, and reads data from one, and finds the patient on the other and then manually types in the data. She's not the only one, there's a room full of them all doing the same thing.

That's something that can easily be computerised by creating an export file from one system and importing it into the other, but needs a "map" creating to match the data fields. Better still to actually properly link the systems so it doesn't need any kind of "bridge" whether manual or computer.

Not only does doing it manually mean staff are needed, it also causes delays and there's a massive risk of erroneous data input when humans are involved.

I suspect the problem is that patients are "coded" in different ways between the systems and it's hard for a computer to be programmed to link Patient Z in system A with a code ABCX1113 with patient Z in system B with a code of fafdf%£123. Apparently a patient's unique NHS number isn't always the code used by one of their many computer systems to identify patients in the computer - different systems allocate different numbers (and different types of number) to patients, so in some systems, you have to search by age, some by surname, etc rather than a common "code" across all systems.

PikachusSmarterBrother · 31/12/2022 12:21

The department I work in doesn't have enough admin staff or managers, so I imagine it varies between departments and Trusts.

iRun2eatCake · 31/12/2022 12:24

My Trust is going over to having digital patient records. Marvellous you would think....

Except...when the patients started coming in to us with no paper medical notes.... we couldn't access the online notes as we'd not been given the equipment to use.

The laptops we now have are so slloowww. The WiFi isn't strong enough to cope ...... l could go on....

Trouble with the NHS no one person overseas everything so whoever decided to bring in the online patient records.... wasn't tasked with actually checking we had a effective WiFi or resources to use.

jevoudrais · 31/12/2022 12:24

7Worfs · 31/12/2022 11:05

if I had the powers, I wouldn’t look to hire more admin, I’d automate.
For example in maternity: each mother is issued a bracelet that can scan QR codes and link directly to the patient record.
Every time there is a round of obs/painkillers etc just use the correct code on their bracelet, done.
Then there can be automatic reminders for repeat actions at certain intervals.
This wouldn’t even be that expensive to set up - a fraction of the failed Track and Trace.
Care will improve so much by freeing up midwives to focus on patients.

This idea has been around for years, look up PLICS. It's expensive to run with little cash saved though. The government don't do invest to save, and the NHS doesn't have enough in its back pocket to do it at scale either. Our funding is only ever very short term focussed.

CarPoor · 31/12/2022 12:26

I would say too many ineffective managers. Not enough admin staff.

A proper up to date system across the NHS would be massive time saver. I think the NHS wastes huge amount of money on subpar electronic systems that don't work and need changing in a few years.

But ultimately I think the problem is the NHS has even running on empty for years, and it gets emptier and emptier. And it's never going to be as simple as employ more admin

pianaoff · 31/12/2022 12:26

The surgery I work in has 9000 patients across 2 sites. Yesterday there was only 4 admin/reception staff in. (Recetion staff do the the admin) we had to close one surgery due to no staff after the one covering was due to finish. Weekly we have 2 or 3 staff at either site. Most shifts working alone.

I blame management & the partners because they only offer minimum wage when every other surgery in our area are on above £10.00 and then incentives on top. No one in their right mind would come to our surgery when the one down the road offers a significant amount more. I only stay because the hours suit me and I don't drive yet but I will be out as soon as I pas my test.

pianaoff · 31/12/2022 12:28

Rebelyells · 31/12/2022 10:57

The number of admin staff could perhaps be reduced if the NHS invested in modern and functioning IT systems that integrated across primary and secondary care.

An example:
In outpatients a clinician sees a patient then dictates a letter, a medical secretary types the letter, someone posts the letter, the GP admin team scan the letter and upload it to their system. This process takes months

We use system1 and all letters are electronic. It comes from the hospital or where ever straight to us. We do get the odd occasional letter in the post and we do scan on record etc. But the rest are electronic.

CarPoor · 31/12/2022 12:28

To update the systems tou need a load of new infrastructure. You need new computers, better WiFi etc. It costs so much. You need teams of people transferring existing paper records to modern computer systems. It's a massive task

Florenz · 31/12/2022 12:29

Tell the staff they can have a pay rise only if they accept modernisation and efficiency drives which will mean the loss of many jobs.

pianaoff · 31/12/2022 12:30

Fathercrossmas · 31/12/2022 10:58

It needs large scale digitalisation. My GP shouldn't have to write a letter to a consultant to then receive a letter back, to then write another letter etc etc to get a simple appointment. It should be an online booking system with no letters! All records in the same place. I know they are trying but the whole system is so clunky.

This is what we have in our area. All letters are electronic and come straight to us through system1. It goes into a big batch and admin then puts onto their records but the system picks up the patients details, we just change to what type of letter it is.

MyNameIsErinQuin · 31/12/2022 12:31

We’ve used the NHS more this year than ever (and very grateful to all of the fabulous people who we’ve seen) and my observation would be that there is an enormous issue with systems. We are at GOSH and have to provide paper copies of letters from local hospital which are then copy typed into their system. GOSH send me correspondence via the app which requires action by Gp. It’s quicker for me to print it, take it to the Gp for admin to scan and send to the doctor than waiting for it to appear directly. Local hospital requires blood test and asks GP to action. I get the letter electronically but the Gp needs paper copy in the post. Which they scan, print, give to Gp who signs, then it’s rescanned then actioned. It’s madness and must drive NHS staff crazy!

Willmafrockfit · 31/12/2022 12:33

the hospital 40 minutes away uses the same computer system as some of the departments where i work, not all.
but in a different way!
and we cannot see what each others input

lieselotte · 31/12/2022 12:34

No, it seems clear to me from what relatives (and people on here) have said that the admin situation in the NHS is dire. Consultants' secretaries generally only working part-time and no cover for the whole week just being one example.

It would also seem sensible to me for GPs to be assisted by medically qualified assistants who could do a lot of the referral letters etc so they don't have to work 12+ hour days doing admin. A GP doesn't need to do every referral letter, many will be very routine and it would make sense for a para-professional to do them, and save the GP's time for the more complex cases and letters.

Willmafrockfit · 31/12/2022 12:35

dont knock part time workers!
it is very behind the times imo to force all staff to work full time

pianaoff · 31/12/2022 12:35

FatAgainItsLettuceTime · 31/12/2022 11:37

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.

In our area it's all electronic and never seen a patient walking round with their own files unless they've asked for all the letters themselves to have. Surely it's on the system already?

pianaoff · 31/12/2022 12:39

Willmafrockfit · 31/12/2022 11:40

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?

In our areas of different surgeries and the surgery I work in. All letters come through electronically to our system. They all sit in a batch and admin/reception will then file into the patients record. The system picks up the patients details, we just need to change the letter type to whatever department it came from. We check if there is any action and if so pass to the GP. I'm honestly shocked all surgery don't work like this.

CarPoor · 31/12/2022 12:40

Jimboscott0115 · 31/12/2022 11:59

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.

An email copy of xray is not diagnostic. You cannot change the contrast etc. You need the image to be on proper xray software.

Hospitals can transfer xrays electronically to each other, but they can't to a dental practice as a dental practice is a private business and not part of the NHS. You can send a copy via email but it's a bit pointless, and again only if the dentist has an encrypted email. This is a dentist issue not an NHS one.

I think everyone thinks "oh just update the systems". But in practice it's not that simple. It's not an easy problem to fix.

The letters seem sounds archaic (although in reality most GPS get electronic copies of letters). But it's not that simple to fix. For example dictating is much quicker than typing, so okay you can send an email which is basically what most letter systems are. You need to be able to talk to each other as clinicians. So what you call each other? But GPs/consultants don't have time to answer each others calls while running a clinic. You type up your own emails? But that takes time away from seeing patients

You book patients straight into a consultants clinic? But then the consultant has no control in who they see and no opportunity to triage - resulting in wastage and also missed cancers etc

Catmuffin · 31/12/2022 12:42

The government constantly finds scapegoats to blame for their failures and underfunding. The Telegraph is their mouthpiece. Constant scapegoating makes this country a nastier place than it was before the tories were in power

EddietheEagle · 31/12/2022 12:42

7Worfs · 31/12/2022 10:55

My only experience with NHS is maternity ward stays. The midwives do a ridiculous amount of admin.
Every time they do rounds for painkillers etc they spend more time documenting what they are doing than the action itself.

That's just basic level nursing. Everything had to be documented by the registered nurse or midwife dispensing the medication, or on paper it has not been done.

This is not an admin task.

CremeEggThief · 31/12/2022 12:43

Eh? Surely everyone knows too many managers is a massive issue in the NHS and has been since at least the early 90s?