Pointless NHS Roles

[ChanelNoFive]

I am an ex-NHS worker. (Department administrator)

Is it unreasonable to think there are so many pointless corporate/non-clinical roles within the NHS. Mainly high up and middle management roles. Examples:

• Events organisers
• Workforce & Organisational Development Leads
• Strategy Leads
• PR/Photographers/Marketing
• Improvement and Culture/Diversity teams
• Roster coordinators
• PMO

Obviously there are non-clinical roles that are essential for the runnings of the NHS. But are a lot of them really needed? I remember seeing all the high up corporate staff thinking “what exactly do you actually do?”

Rostering for one ward used to take a Band 7 2 days a month. Now a Band 3 does it full time for a whole department. Money well spent.

90% of the admin roles in the NHS aren’t required including department admins. Hospitals need access to centralised admin teams in the NHS rather than local ones so referrals etc are consistant & AI search needs to be added to hospital websites to make them truly useable.

Some ICB middle management jobs are pointless, you could cut out two ofnthem
in the chain at least

Loads of middle managers, that I have no idea what they are actually doing. We don't see them!

Surely a workforce and organisational development lead is basically HR plus sorting recruitment etc?

That sounds pretty necessary.

How do you consider your old role?

For a very short time I worked for my local CCG in admin. It was the biggest eye-opener ever. So many people, all earning a good wage with 'head of' job titles. Not clinicians. Just pen pushers. I was astonished - most of them appeared to do very little other than arrange meetings with one another - there appeared to be very little output. I was told that the CCG started with 3 staff members and had grown in about 5 years to about 60 plus some volunteer board members with healthy expenses. It was an absolute joke. My role was admin and there was 3 people in the same role. There was nothing to do, other than answer the door buzzer and make tea for the higher-ups. I left one day and just never went back. If this is what the NHS is like through and through I'd say there could be a good bit of pruning without any ill effects.

I can see a reason to most these functions. Correct me if I’m wrong but some of these roles would surely be part of larger departments - eg workforce and organisational development would be part of HR. Also, photographers, PR and marketing might well be outsourced on an occasional basis and events may be largely organised by friends or be people with other roles such as training or research.
With many of these titles I can see them helping to reduce workforce attrition in what we all know is a service under serious stress.
I don’t know what a PMO is though.

Whilst I see your point with some roles, unless you’ve either done them or had very close exposure it can be ignorant to just presume they’re pointless. For example I know someone who works as a ‘roster coordinator’ (different title but same role) for an NHS trust, responsible for the scheduling of hundreds of staff; they work extremely hard and their role is very much needed.

Boring. Slow paced. Unfulfilling.

My ex-Trust and the NHS in general need a complete overhaul for centralised and modern systems. Wouldn’t need has as many admin staff if systems were fit for purpose.

totally agree that there are loads of unnecessary people in management in the nhs. Also in “policy” and public health, etc. I used to work with a related organisation and there are people being paid as much as relatively senior doctors who do nothing of any use. It’s not the only issue with the nhs but poor management and unnecessary staff in those roles is one of them.

They were all part of HR but different roles.
HR managers. HR representatives. HR specialists. Talent managers. Talent acquisition advisors. Workforce and development leads in each department. There were probably more.

Equality and diversity managers, it's amazing how many roles develop in response to the latest gov fad and then become part of the furniture

You are right. The NHS wastes so much money on high banded roles with no real purpose.

The NHS is the largest employer in Europe and one of the largest in the world and is still so inefficient - too many roles don’t provide a direct positive benefit to patient care. You could argue it’s currently a massive employment retention scheme keeping many off the unemployment list in jobs which are of minimal value to the core NHS fundamentals of delivering healthcare. Throwing more money at the NHS won’t improve the care provided in its current set up. It needs major restructure and realignment and reinvestment in the value add roles to deliver patient care. Do that and it would also improve staff morale.

A lot of money could be saved with more centralisation, but it's a long way back from everything being done separately in each individual trust.
And no-one even has IT systems that interface.
Depending on your political/social views, you may also have opinions about nursing manager-level jobs with sole function of 'increasing diversity'. Since most nurses at local city hospital have been 80% recruited from abroad, the diversity required may not what the recruiting officer intended.

Middle management bloat really has been the bane of every place I've worked. I don't really care if the CEO is on a huge salary with benefits, dividends, share deals, whatever, if they are heading up a successful company good on them. But when there are layer after layer of well paid "management" who contribute nothing obvious at the expense of the actual workforce who do the deliverable work its hard to tolerate.

I used to work in a technical role where we interfaced directly to the customer, we'd often get, and extend, contracts through the good relationships we had with them. Then it was decided this was not the right way to do things so extra managers, on twice our pay, were brought in to do the interfacing and we were effectively forbidden from talking directly to the customer. Within a year the work had dried up. The "workers" ended up redundant and the "managers" kept their jobs.

Bitter? Moi?

Yes this is the bit I dont get.

We went to some meetings about doing a deal for a new GP surgery.
There were about 5 GPs there (with all their advisors), multiple "head ofs" from the CCG , plus their advisors, more senior managers from the local NHS trust and their advisors.

And nothing ever got agreed. They were all negotiating with each other and couldn't agree on anything.

Somehow we need to get rid of some of the tiers and the structure, it was mind boggling

It should have been one party plus their lawyer , not this huge gaggle of people most of whom knew nothing about negotiating a property deal

With the shortage of doctors, and logical outcome of paying them 35% more meaning you can afford 35% fewer of them, the case for paying very senior and experienced clinical nurses (as opposed to non-clinical nurses) more is very strong.
The NHS would retain more senior and experienced nurses if the the pay scale didn't just effectively stop at band 7 for most clinical nurses (unless another apprenticeship is done to be an advanced practitioner, which takes another 2-3 years of uni study, or a very small amount of other band 8 roles, basically most band 8 nursing roles are non-clinical middle management desk-based roles). This would stop a lot of senior experienced nurses having to move into non-clinical middle management roles in order to get a promotion to band 8, taking with them all their clinical skills.

This is a classic example of a member of staff who is completely ignorant about the inner workings and background work that goes on to ensure day to day functioning of an organisation as a whole entity.

PR and marketing, for example, deal with hundreds of media enquiries, publicising of public health messages, organisational reputation, engagement with specific patient groups, organisation and maintenance of intranet / staff communications etc etc.

As another example, Improvement and culture/diversity teams are absolutely needed to drive cultural change within the NHS as well as represent and engage with cultural / ethnic minority patient groups, educate the workforce on different cultures and the impact they have on how we carry out our job, contribute to diversifying the workforce and contributing to improvements in staff wellbeing. Have you not seen the damming reports on sexual harassment and misogyny within the NHS?

Event organisers in my Trust are either those who organise / manage clinical cover for large events such as premier league football matches, music festivals, royal visits etc etc. or those who organise smaller things like school, youth group visits, public health events such as restart a heart, 999 family days etc. Again, roles that are required if these events are to remain in place.

Roster coordinators are essential to ensure cover is planned according to operational need and projections. This includes managing annual leave, roster changes, organising relief and overtime shifts, scheduling staff on to training and backfilling their line…etc etc.

Of course, there are some roles that could be combined, left vacant, or not exist at all but none of your list would be one of those.

• Events organisers - Trusts are expected to do income generation these days. So yes, events organisation will be needed to facilitate bids for the provision of services which a trust can charge other organisations for.
• Workforce & Organisational Development Leads - Because of the constant demands for change (to meet changing demands due to demographics, to find cost savings, to deploy the available workforce effectively) - you need people to keep transformation work going. Transformation is never ending because the demands change year on year. This group of staff are responsible for ensuring that departments have the right kinds of staff in the right places.
• Strategy Leads - Necessary because a lot of services by their nature work together with non NHS organisations, and aligning strategic goals saves money.
• PR/Photographers/Marketing - See income generation above. A few interns on work experience won't cut it any more, you need professionals. Our PR/Photography/Marketing team for a Trust about 4,000 strong comprises 3.5 WTE, only one of whom is a Band 7.
• Improvement and Culture/Diversity teams - Understanding your staff and your patients leads to better outcomes for everyone and avoids expensive lawsuits. Again, these teams tend to be small. Fewer than 3 WTE in my trust.
• Roster coordinators - Have you ever done any rostering? You shoudn't even need to ask why these people are essential, and they are generally on a low band.
• PMO - You can't do income generation, innovation (new and better treatments/systems) and transformation without project management.

If you cut the admin/back office staffing, you get clinicians having to do even more of it than they do already. Now that's expensive - a Band 7 nurse doing the work a Band 3 admin should be doing.

Event organisers form part of the charity fundraising so are required.
Workforce and Organisational Development leads are essential to ensuring appropriate staffing - links to strategy.
Strategy leads set the direction of the Trust (along with other things), whether you agree or not is another matter. Sometimes falls under W&OD, sometimes doesn’t but both are linked.
PR / Marketing is good because it gets donations, brings in private business and helps compete for funding.
Culture / D&I is useless, I agree.
Roster Coordinator is essential.
PMO is essential to ensure projects, programmes, and portfolios are delivered within the Trust.

Overall, I think you lack the wider knowledge and / or experience of the NHS posts and how they interplay to ensure the smooth running of the Trust. I suspect from your wording you weren’t high on the totem pole so a lot of it went over your head.

@chaostherapy I agree- the current system does nothing to retain the most experienced nurses on the clinical floor, rather it encourages them away

I can see a need for a roster coordinator- the rota can be really time consuming and complicated, especially when you add in shift work, flexible working and other considerations. As well as a need for many of the other posts, articulated so well by previous posters.

There are a number of other roles that remain a mystery however......

The last few posters are eloquently defending the necessity of all those job titles, but have spectacularly failed to grasp that the majority of the population don't see the need for all that fluff and just want access to good healthcare (and know full well that the fluff is an invented construct to justify the continuing and unnecessary drain that the NHS has become)

We need to massively cut back on useless jobs like that and redirect money to the frontline. Then at the same time streamline front line services