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?”

@Handsan "The NHS is a £180bn business with 1.6m patient interactions per day. An operation of that size doesn’t run itself. As previous posters have pointed out the evidence is that it’s under managed not over managed".

Well said.

OP have you ever actually done any research into the work done by the people who hold these roles and how they benefit the wider organisation?

Or is spouting kneejerk, uninformed bollocks more satisfying?

I work as a theatre nurse, we have to go through 3 lots of technology input per patient before we start operating. It adds up to hours of time taken away from actual patient care. Can't wait to retire next February!!

This is not limited to the NHS, although the fact that it is publicly funded and it to serve a purpose is what is astonishing. There needs to be a complete overhaul, but how can it be achieved? I know many NHS clinical & non clinical staff. Including HR personnel. Absence levels amongst non clinical staff is astounding. It’s cultural. It’s seen as an entitlement. For profit and corporate organisations don’t tolerate it & these people & poor performers are managed out. It’s impossible to get rid of most public sector staff. Instead ‘natural wastage’ is the only means of staff reductions. So effecting cultural change and organisation will be slow.
The NHS is a desirable in my area for non clinical staff. Rates of pay are significantly above average, even for junior level administrators, as are terms and conditions. Permanent staff numbers are inflated to cover the c.20% absence rate. It’s madness.

How do you expect any transformation projects, innovation, or any income generation/cost saving projects to happen with out any project management (PMO) staff?

You have clearly no idea how large organisations work. Yes it's 'Money redirected from the front line' (but its not though is it, you wouldnt say rent for premises is redirected from the front line) But it's absolutely needed in order to restructure or manage the front line.

If they weren't there, how would projects such as the implementation of a new routine health check for ex-cancer patients across a whole trust or the installation of new multiple medical machinery which could be life changing in terms of effectiveness happens? Arguably, these examples are important, positive things for public health but Front line staff such as nurses and doctors wouldn't be able to ensure that's done within budget, time, and scope - because that's not their area of expertise, nor would they have the time available or desire to do that role.

Backend people are needed - whether you want to pay or not.

Beware people offering simple solutions for complex problems.

Why pay one person to do a job when you can pay 6?
This seems to be the NHS ethos nowadays

Well in my trust there was a 2 hour on line talk on ‘understanding bisexuality’ as well as other such bullshit.
As a front line worker who is almost at burn out, I honestly couldn’t give a shit about what consenting adults do in their private lives.
Id prefer more trained staff, better pay and real attempts to retain and support staff instead of this kind of crap.

Do you have any idea what medical photographers do?

You know when you see pictures of things removed from people, or the damage caused by an accident they are taken by medical photographers. Photographs of things like tumours contribute to medical research.

They also film operations, particularly if it is an unusual one. Things like the separation of conjoined twins.

Some do ophthalmic imaging.

Where do you think those images in medical textbooks come from?

Maybe learn a little bit before you judge.

I echo that the CCG’s (now ICB’s) are the main source of the issue with management that isn’t necessary, I work in healthcare and have worked in most sectors including primary, secondary and community settings and this is the area that is most dysfunctional. I now have 2 locality managers for our locality doing the same job but one is now good cop the other bad cop and both of them have to come to every meeting and respond to every email. However they don’t respond to most emails and are both on leave at the same time quite frequently it is so frustrating. They don’t seem to ever know anything and the few times I’ve had an emergency situation I’ve needed their help, all they do is bring in 5 other managers to the situation and you have one giant meeting where everyone just talks and nothing gets done.

Oh and rostering managers are one of the most important members of a team!

And they don't already know that??

*You sound like a passenger to me, get off the bus.

But if a government was actually brave enough to kick you all out, dish out the P45s what would you do?

Don';t worry, it won't happen!*

FFS, do you honestly think that an organisation the size of the NHS can just bumble along with no forward planning?

If a Government did kick these people out, they'd probably end up paying 5x more on consultants to do exactly the same thing

Not sure they had ipads 30 years ago.

You need strategy; even in a small business. You can’t just bumble along with no purpose, growth or plans. Unfortunately what happens is that the budgets do not always match the plans so projects take a long time or are shelved but if you don’t even try to progress forward and make improvements then this is when things become stagnant and more likely to overspend. You have to be looking around you all the time to find an area to cut back, grow or change

I have been a hospital consultant for 30 years. We need roster coordinators. Esp during the strikes and planing oncall rotas for the junior doctors. The rotas have become so much more complex over the years that there is no way a clinician would have time to do that.

So we need roster coordinators thanks. If you don’t understand why, then I am not sure you know much about how the nhs works.

@GoogleWhacking

Again - wasn't suggesting they did but in a MaxFax department where they no doubt photographed lots of pre and post op stuff I would have expected them to have had a departmental camera that one of 8 highly qualified medics could have taken a photo on, rather than having to draft in a photographer! I expect that now medics would take their own photographs on an NHS issued (and regulated) tablet/phone hence no need for a photographer. But seemingly (according to the OP) NHS photographer role still exists!

I'd like to add 'Pain Manager' to your list.

One of the funniest bits to my husband's accident (and there weren't very many) was the day the Pain Manager visited him on the trauma ward with his shiny shoes and shiny clip board to administer a self press morphine button. His orthopaedic surgeon came along a couple of hours later, took one look at it, literally ripped it away and shouted "who the fuck thought this was the answer?" We went back to intravenous morphine to the point of being comatose. Pain Manager indeed.

Is this a serious question? How the fuck would they know which ones are empty without looking?

Exactly this.

I don't dispute the need for roster managers , PMOs, Comms etc

But why are there so many different organisations all negotiating with each other?

As the outsider (we had land they wanted) it was mind boggling to go to endless meetings where different parts of the "NHS" were all just arguing with each other, with lawyers and surveyors acting for each bit of it too and brought along to every meeting ,.years went by and all they did was argue with each other!

@SpaghettiWithaYeti they are so useless. I’ve needed their help twice this year as they have contacts I don’t have, to help me coordinate urgent situations and they don’t know anything so I wasted hours chasing them around and ended up just finding out all the info myself, they are literally the COMMISSIONERS so why would organisation A need to directly contact B,C and D to ask for authorisation for something quite high level, I assumed that’s why my ‘locality managers’ role was actually there for. Turns out not

Another person shilling for those who want to sell off the NHS.

I used to work in PR (not for the NHS). Loads of people thought we were a waste of space, until they really needed our help. You shouldn’t rubbish other people’s jobs when you have no idea what they do.

YANBU. I see the same with devolution of powers, ie Scotland and Wales (Northern Ireland is slightly different) having their own governments. We try to bring powers closer to people and concentrate it, which then leads to more departments being needed at the top. You end up with departments being replicated. For example, every NHS trust and every NHS hospital ends up having it's own procurement buying from different suppliers, often at crazy markups.

I think the NHS makes its own case to be sold off with how much money it wastes and how inefficient and sluggish it is. I'm not saying it should be sold off, but I do recognise that it needs a major overhaul, and nobody seems to know how or has the courage to take on such a mammoth task. It would be political suicide to do so.

As an example; If your car was inefficient with fuel, slow, broke down every other week and didn't start or took ages to start every other day, the chassis was falling apart, the windscreen was covered in cracks, the wingmirrors were broken and maybe were held on with duct tape, the tyres kept going flat and/or are bald etc you'd sell it, or get it fixed if it was worth it and/or you could afford it. The NHS is that car.

The NHS is the largest employer in the country, so it's obviously good at giving people jobs, but those jobs aren't making it efficient or cost-effective, they are making it bloated and unworkable. It's getting so big that when (not if) it collapses, it'll take out private healthcare with it.

People are worried about it being privatised because they know they'll need to buy insurance to use it, but at the same time, they also know it will stop it from getting abused like it is now. They worry that an insurance-based system will mean a copy of the American healthcare system. They forget about the other healthcare systems in countries such as France, Germany, Australia etc

Something has to give, and it will, it's a matter of time.

Tony Benn NHS boatrace story - an allegory of the British "management" issue.

The NHS held a boat race against a Japanese crew and Japan won by a mile.
A working party found the winners had 18 people rowing and one steering while the NHS had eighteen steering and one rowing. So the NHS spent £5 million on consultants, forming a restructured crew of four assistant steering managers; three deputy managers and a director of steering services. The rower was given an incentive to row harder. They held another race and lost by two miles.
So the NHS fired the rower for poor performance, sold the boat and used the proceeds to pay a bonus to the director of steering services.

And yes, he said that, here is the hansard: https://publications.parliament.uk/pa/cm199596/cmhansrd/vo951122/debtext/51122-36.htm#:~:text=boat%20race%20between%20the%20NHS%20and%20a%20Japanese%20crew

Which is great rhetoric but factually bollocks, as Japan spend 1.8% of total healthcare spend on administration/management, vs the NHS which spends 1.9%, so essentially the same. Both have amongst the lowest spend across OECD countries.

PP mentioned Germany and France, they are spending 4.4% and 5.5% respectively. The US spends 8.9%, much of which is to do with advertising and running insurance schemes.

Culture is downstream from law. The Equalities Act plays a huge role in this.