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?”

The bollocks in this thread (illustrated above) is stunning. I worked for over 30 years in the NHS until retiring relatively recently. I worked in several NHS Trusts, in various departments, eventually as Clinical Lead - so you know, one of the ‘too many Managers’, who was also a nearly full time Clinician, managing the Clinicians in my Specialty over a locality (3 districts). In so doing, I was regularly in contact with and using the services of lots of admin teams. Standing around talking would happen at quiet moments. The rest of the time, they were running their arses off, working hard for patients and clinicians!

A plague on all your winging houses 🙄

When a national health service fails to communicate between one health authority and another, it’s a broken system. Live on border between two, they refuse to share simple blood tests between each other. So twice the cost to NHS when, for bonkers reasons, I need to get two sets of blood tests. Do not understand.

@AnnieSnap anyone can claim to be anyone on here, I know from my own experience how busy NHS admin staff are.

Yes, true

This thread is a great lesson in people who have gone to the "University of what my friend told me" with PhDs in "repeating things from provocative opinion pieces".

:)

Sorry, honestly, just saying her experience. I have total respect for everyone who works for the NHS, I really do. I was agreeing that some roles are superfluous to demand, which in this case is a boss who could have actually managed it on his own but demanded extra staff, not one but two. My friend is pro active but a lot of the time she was sat around doing nothing and was bored, frustrated and applied for other jobs because she's a doer.

I know and respect most NHS workers are run off their feet and live in the real world and hats off to them. The post was about unnecessary roles so that's all my response was, as any profession, there are some areas which are disproportionately and unnecessarily overstaffed and others which need more. Xxx

Whilst I don't know enough about the workings of NHS Trusts and the need for full time staff in each of those roles, all I will say is that if it were a profit making organisation, there would probably be a third less staff in the NHS.

@NoveltyCereal You are totally wrong, there would be many more staff.

@NoveltyCereal on second thoughts you are right. Many more people would simply not get health treatment so the number of staff could be cut.

@NoveltyCereal

I think we can all see with the way that the private industry has handled water and how companies like Carillion, G4s and many others have so poorly managed their public contracts. That the private sector is no bastion of efficiency.

Yes exactly 'public contracts' so not commercial ones.

Also you're talking about a handful of large private companies out of a pool of hundreds and thousands. In addition, the NHS can't fail because it is funded from the state so it's existence is in no way an endorsement of it's efficiency. The Departmental budget cuts since 2012 have shown the insane amount of wastage that was rampant in public sector finances. Those level of cuts were not enforced on the NHS but should have been.

"Also you're talking about a handful of large private companies out of a pool of hundreds and thousands"

There are hundreds and thousands of examples of private companies that mismanage their costs.

". In addition, the NHS can't fail because it is funded from the state so it's existence is in no way an endorsement of it's efficiency." There are other ways of looking at its efficiency though, the Kings Fund do a good analysis, which up until the reasonably recent past has always been good on value for money, costs etc.

"The Departmental budget cuts since 2012 have shown the insane amount of wastage that was rampant in public sector finances. Those level of cuts were not enforced on the NHS but should have been."

Hmm, no they really didn't, and have you seen the state of public services in this country? Departmental budget were cut to the bone for ideological purposes with the front of "efficiency" as an excuse. I'm sure having local swimming pools, libraries, management of public spaces, youth centres, filling in potholes and much more has been cut because of wastage.

I'll wait for you to mention diversity managers though
:)

Having worked directly on public sector finances previously I can tell you they most certainly did. Departments that had their grant in aid funding slashed by a half continued to operate at the same levels as they did previously and much of cuts were not funded through laying off staff but simply giving up expensive rentals or sharing space in buildings.

The potholes, libraries etc are a local authority issue and not a central government one but I do agree that local authorities funding/finance are in a significantly worse position and this is more apparent because they directly impact public services whereas a lot of the departmental cuts did not.

I have no idea what your comment about diversity managers relates to but if efficiencies need to be found, I'm sure there are more important roles that would need to be kept ahead of that.

If the NHS was profit making less patients would be seen as organisations would be limited to their budget rather than overspend as they do now. When commissioners allocate costs and monies for each activity once the activity had been reached those services would cease until the next financial year. I’m not as close to that data as I once was back in the day but there was one time where the only activity that made a profit in a hospital was death on arrival as it cost around £45 and the payment was around £70, all other services ran at a loss. Whilst there are efficiency and cost improvement programmes in almost all nhs hospitals people will still get ill and need treatment, the budget will always be the budget and overspend will still be expected to be recouped at some level. Less staff for the most part will impact on volume and quality of of care provision and yes there are systems and digital solutions that may help they are expensive, and private enterprises charge the NHS through the nose to provide their products and services. Against a back drop of Covid recovery, recruitment and retention issues and the cost of temporary staffing, high absence rates and long waiting lists and cost improvement programmes it’s difficult to try and piece all this together in a way that serves everyone well including the tax payer. When you start unpicking things you soon realise the interdependencies and the complexities to even try to positively impact the services provided at a fair cost. If the issues were simple to cure it would’ve been done before now.

"Having worked directly on public sector finances previously I can tell you they most certainly did. Departments that had their grant in aid funding slashed by a half continued to operate at the same levels as they did previously and much of cuts were not funded through laying off staff but simply giving up expensive rentals or sharing space in buildings."

Yeah yeah. This is why standards of public services have plummeted since 2012? I don't believe you.

"The potholes, libraries etc are a local authority issue and not a central government one ". Tell me you know nothing about how councils are funded without telling me...

I actually don't believe all the hype about "inefficiency" in the public sector, its a well worn trope used by right wing governments as an excuse for slashing funding/redirecting it to their pet projects.

We didn't keep working at the same level, we had to start cutting corners that made us uncomfortable and carried risks, worked unpaid overtime, worked till we were ill

The output may have looked the same to you but the consequences weren't

I actually just left my PS job because my health was totally broken after years of trying to do the work of 5 people. Long evenings, hyper pressured days, taking risks and making judgement calls about what corners you can cut (some of these may have huge cost consequences later down the line and we regularly flagged this)

I'm back in the private sector now and it feels like a holiday in comparison

Oh and now I have left it's costing my organisation a fortune in contractors and outsourced work to cover my workload

@SpaghettiWithaYeti

This sounds much more like it.

Any bets the PP was a management consultant :)

Oh how we bow down to the craven cult of consultancy.

I think the original post shows a lack of understanding about the roles themselves. Other posters have covered off these roles so I won't add to that, other than to say in the NHS only 2% of the workforce is made up of managers - the rest are in key front line roles. This is very lean, in other organisations, particularly the private sector, management would be made up of at least 5% of the workforce.

Managers play an important role- would you rather get rid of 'the bloat' in the NHS and then have consultants organising ministerial visits or running an event setting out the objectives of the hospital for the year, instead of performing your nan's hip operation? Or would you like nurses to move away from patient care to organise the rosters for the next month?

Clinicians are already over stretched - and without that 'management bloat' they would have to pick up these roles. And yes they are important because a lot of them stem from laws and regulations that all businesses have to comply with.

Unfortunately I think you are picking up on political soundbites which are made by people who don't have a basic understanding of the NHS and the pressure it's under. Which is worrying in itself!

Not just nurses. This happens with laboratory staff too. I never wanted to be a 'pen pusher' so stayed at Band 7. As you say, non-clinical roles shouldn't be the only option for advancement ( and pay rise)

Having worked in both the NHS and the private hospital sector my experience is that the private sector employs more people to deliver the same outcomes.

Also healthcare should run the opposite of a profit making company. To make a profit you want customers who keep coming back and ideally spending more.

In healthcare you want people to be cured and not come back. Unfortunately that is not always possible.

I've worked in both as well, and this has long been the case. Also, when private sector managers come to working in the NHS they say a lot of myths they always believed are suddenly debunked. The government of the day has always spouted bullshit about the NHS -quite on purpose-to suit their political agenda. I worked in the NHS in Thatcher's day-just about-and I've seen this time and again. The subject of the difference between the public and private was also a favourite discussion point at region wide senior management development days out, with people across both sectors, and not much disagreement between them.

@SpaghettiWithaYeti @Aladdinzane

As you say, the outputs are same i.e. they are still coping and carrying out the remits that are required of them. The consequences on staff will be a HR/employment issue as with all companies.

But they aren't. The outputs look the same but later down the line there are expensive consequences

Eg. Legal documentation is poor or issues are missed that come back to bite at a later date. I have seen this happen and seen the cost consequences be many multiples of the original "savings"

And it's not an employment /HR issue - replacing my role (because they can't fill it) with contractors will cost many multiples of my salary. So pushing me till I broke in a hard to recruit market will cost the organisation an incredible sum

I understand to some extent but we're talking about cuts made over a decade ago and things seem to be running fine at a Departmental level even if there are a few blips here and there. I'm sure blips existed even before the cuts.

Ultimately if Departments are able to absorb contractors costs then all this shows is that there are even more efficiencies to be found OR that they should focus and invest in employee welfare and retention.