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?”

That's the whole point of it being an allegory.

I agree with a lot of this.

I don't think there are many unecessary roles in the NHS although there are definitely some unecessary people: the problem is that you can't get rid of them. You cannot. The unions are powerful and the terms and conditions are unbeatable. People will stick around like a shit in a jelly for 20 years. Everyone knows they are toxic and bring everyone down, but you're fucked because you can't do anything.

I don't know the answer, because it's unionised because it's huge. I actually wonder if some privatisation might help, within a ring-fenced social insurance type model. But it's complicated.

Regarding inclusion roles - there is debate about whether they help an organisation's culture. I suspect not. But the NHS has the highest percentage of foreign-born staff of any large organisation in the UK. And they are subject to awful conditions and racism from staff and the public. That's what inclusion staff are needed to support.

Ok so this is my short answer.

We cut all of the 'unecessary' jobs, and then the doctors and nurses (because surely they are the only necessary jobs) just stand at the gates wondering what to do?

Who pays people? Brings patients to theatre? Orders supplies? Arranges diagnostic testing? Looks after the carpark? Recruits people? Makes sure that all of the right people, are in the right place, at the right time, with the right equipment and training, and are ready to work? Oh yeah, that'll be the administrators.

Is the NHS underfunded? Yes. Is it inefficient? Hugely.

And my top insight - it's not really the unions that hold things back - it's the boards and Non-Execs. No-one in these positions wants the 'bad publicity' of sacking someone even if their practice is terrible, or they case huge disruption. Pay-offs are exceptionally difficult to arrange. So they stay, and infect and drag down the rest of the otherwise skilled, motivated and available workforce.

My dad worked for a huge scientific organisation in 'the olden days' (1950s - 1980s). They had a rolling competition where any staff, manual workers through to management, could submit their sensible and serious ideas for saving money. It was the front-line workers who were often the ones who could see the issues that would benefit from change. I'm not sure if the competition happened monthly or quarterly but prize-winners whose ideas were subsequently implemented were given cash rewards (probably a few hundred quid in today's money) and they were announced in the staff magazine as well. I remember hearing about ideas from practical every-day or organisational ones, to specialist ones which improved industrial processes. Some of the best ideas saved the organisation a great deal of money so the prize cash was insignificant in the overall budget. I keep thinking that something like this might work really well in the NHS. They might need to treat it as a loss leader at the beginning though because there's so much that seems to need fixing.

If anyone is in any doubt as to the benefits of the NHS and NHS managers this is worth a watch

Oh fuck off. It takes a lot of people to run an enormous organisation like the nhs. Yes there will be some waste, people who could work harder etc etc. but there is so much work that needs to take place to manage the business that the nhs is, targets to be reached, regulatory activity - all of which is needed to get the funding from NHSE every year. Who do you think is going to do all of that?

If you doubt the value of procurement watch from 5mins 20 seconds in.

Too right @Duckswaddle . A heap of bigots who actually understand very little about either the roles they are criticising or the administration nhs in general. Either that, or the Reform party, who are Trump playbook and in the business of gaslighting everyone to get their grubby hands on the NHS. It definitely wouldn't be to the benefit of the population.

No, if I’d said “but the NHS isn’t a boat” I’d have missed the point about it being an allegory.

For it to be a useful allegory it needs to illustrate something accurate, the allegorical point here being that there are not enough “rowers”, presumably clinicians, and too many “steerers”, ie managers. Except Japan has the same proportion of rowers to steerers as the UK. So it’s a crap allegory that illustrates a lazy point which isn’t factually accurate and to be honest Tony Benn should have known better.

Background in charity, was once a service manager in a partnership program with the NHS. We had monthly meetings. There were at least 9 people in the room, including my opposite number from the NHS team, my boss, her boss and a bunch of people whose roles I never worked out. The only people who ever came out with anything to do were the other service manager and me. We could have sorted the stuff needing to be done between us in 10 minutes. I was astonished at the amount of people the NHS felt had to attend.

Lots of moany departmental administrators in the public sector. Many, not all, have a lot of opinions but actually aren't very knowledgeable or efficient and haven't modernised with the times in terms of work practices.

We can't afford their redundancy packages so we're stuck with them for now while they cruise to retirement - or AI replaces them altogether?

Sound familiar OP?

I absolutely agree! My husband worked in facilities for nhs for a short while. Although FM is pretty important, he was middle management on a half decent wage but just spent all day on teams talking about pointless shit. They would do about 6 different audits for the same thing every week and don’t even get me started on how long (and how many staff) they would spend in meetings discussing menus, when in this particular hospital, it was all regen micro meals, was absolutely ridiculous. Then was all the money they would waste printing and reprinting menus or buying curtain hooks and then rebuying because the ‘rules’ had changed. He only lasted 6 months!

Isn't that article management saying we need more management?

The OP is not saying get rid of management and other roles, it is just, as many posters have shown, that the NHS is bloated with people doing 'busy work ' with no good effect: so many posters mentioning the culture of meeting to discuss meeting with conclusions which are changed the next week at the next meeting, including buying products which are incompatible with items in use (eg given:curtain hooks). Of course the NHS needs management, but the current setup does not work.

@HoppitySkippity they already do the thing of asking frontline staff for their money saving ideas. If there's som corporate bollocksy method for saving money you can guarantee the NHS has paid lip service to it.

If the NHS is the best in the world, why has no other country in the west ever emulated it? Is it because it's so good that other countries just can't top it, or is it so crap that other countries see it as an example to not copy?

My mum used to work in the NHS and told me that loads of money gets wasted on pointless things that could be better utilised elsewhere in the service. It’s been going on for years.

@Pudmyboy no it's not, it's independent research.

This thread just demonstrates that the OP and many others don't understand many roles in the NHS and just subscribe to the oft repeated whine of the tabloids etc that there are too many managers, even though research shows the opposite to be true.
All the examples given by the OP are bad ones as they all have an important role to play, so despite having worked in the NHS, the OPs knowledge is limited.
I'm an occupational therapist. So I'm a clinician with a viral role within the NHS. I have seen articles in the paper and posts on MN that mention OT when discussing "pointless jobs" in the NHS. I'm still surprised when I see it, but there it is. A really good example of someone with no understanding of what they are taking about deciding that an established clinical specialism is actually a pointless waste of money purely because they don't understand what it is.

By the front line do you mean doctors and nurses? I thought you didn't believe in paying the front line more??? Streamline which front line services?

It isn't the best in the world - but no system so far has been shown to be brilliant. All have pros and cons. The biggest pro of the UK system is that everyone can get help. The biggest 'con' is that it is tied up in politics so much that no one can long-term plan.

Thanks, but who commissioned it, what were the parameters, what data sets used? I know from working in a lab years ago, that data can be 'massaged' to suit the outcome that the commissioner desired

Thanks. I find people that write posts like the OP do so without understanding the jobs. I remember my job role being rubbished by someone when it was advertised in the local paper. It was a stupid job title, but it was also an essential job and I brought extra money into the Local Authority from private business. Without my job we would not have had private businesses paying for lots of local children's events, parks and museums.
The NHS has far less admin than other comparable organisations.

You don’t know what they are doing, so how can you possibly judge that whatever they are doing is unnecessary?

Is there an organisation comparable to the NHS?