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?”

@Ozanj
"Ozanj
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."

I work in a community team with several admins the several streams that we have. All very experienced and very busy.

Question - you centralise our admin. Who then answers our phones and signposts the callers to the right people? We have a LOT of calls throughout the day. Often our administrators can help the caller without it needing to go any further as they have fantastic knowledge of our service, service users and their needs. So much more than just "admin"

@allthevitamins centralise admin is the kind of shit that management consultants say. I agree that too many people undervalue admin and think it is all the same - bit of typing on the PC and phone calls - so anyone can cover for anyone else. It is because it is mainly women who do the job.
I worked for a private company where we had our own departmental finance admin staff and a central finance staff team. A management consultant advised they got rid of the local finance staff. Within weeks it was a shit show. The consultant had not realised that all the managers of teams used the local finance staff team to help them manage their budgets. The local finance team were always working out finance spreadsheets, doing finance reports, and writing out finance updates. They were two very underpaid women and getting rid of them saved hardly anything even on paper. Instead the team managers suddenly had to learn how to do lots of new things, including how to use the complex central finance online system to get the info they needed. They ended up having to pay for training on using the online finance system. It will all have cost far more money in the end.

Oh and another thing... all of those managers / commissioners - they're supposed to be scoping and quality-checking all of the outsourced work that is going on.

OK so how about we just employ people directly then and manage them ourselves....

I think that people really fail to grasp how enormous a job this is.

If the main focus of the NHS is to promote health and wellbeing and treat ill health - then there are a massive range of types of jobs involved in that. Yes - doctors, nurses, scientists, therapists - but also porters, estates staff, IT specialists, finance people (just because it's free at the point of access doesn't mean there aren't billions of pounds moving around the system), plumbers, cleaners, decorators, photographers, events managers, volunteer managers... I could go on...

So if we're specialised in delivering healthcare, are we really the best people to recruit, train, line manage, control the output of, and develop our plumbers and electricians? Or should we outsource that? Because in theory there are probably businesses out there set up to do just that - doctors and nurses really aren't good at that?

So many people so vastly underestimate the scale, complexity, and yes, actual costs involved in running the NHS that it's just too easy to say yes, we'll order the cheaper pink paperclips, or we shouldn't bother counting the hand sanitiser (but should we count/keep track of our medicines that perhaps cost tens of thousands per dose?).

I was a major supplier to the NHS in the technology area. To say they are backward and unwilling to look at new technology is an understatement. Many many people I came across were just trying to keep hold of their roles and they didnt want say a central Procurement Team.

They kept clinging onto their old systems regardless and the systems are stuck together with bits of tape. Nothing must change. We dont want to have to train the workers with anything different. At one point one of the trusts stated they would like to keep old system and not have them maintained - they would take the risk!!

We had to refuse because ultimately in the event of any outages the supplier would be blamed regardless but everytime we had a meeting a cast of 1000's would appear and they went on and on and on. Nothing was ever agreed becasue that might mean their job was a risk so on we went...

At one point it was very clear that they would save £100,000's to change to a new contract and when they finally did sign they asked whether the cost saving would be back dated! I have already stated that any cost savings would only apply once a signature had been obtained but they were truly shocking.

Luckily I dont do that role anymore but the NHS is a monster that needs urgent reform.

Why are you being deliberately obtuse!! It does not make you look cleaver as you full well know what I am saying, understand!!

@allthevitamins the problem is there is no flexibility then. Sometimes you just want a painter to come and paint a small part of a wall that has been damaged. But that requires changes to the contract including quotes, so it does not happen as the process is so expensive.
We see it in meals being contracted out. Trays of food out at a certain time and collected back at a certain time. It does not matter if a few patients need those trays for longer, the private company will not allow it because their staff finish at x time, so the job needs to be done by then,
Employing staff directly allows way more flexibility to respond to the actual needs. It is why the best food I have had when in hospital has always been that provided in house.
The private company I work for has sites all over. They area specialist technology company and used to employ painters and maintenance staff through a contract. It caused loads of issues with a lack of flexibility. They now have in house staff again.

To add to that...
Strategy teams are there to help us implement the endless plans and policies that the govt throws our way. Plus every large, complex organisation like NHS trusts need to have a plan for what they are going to deliver for their population and strategic managers are responsible for doing that.

Quality improvement teams help us to identify improvements that we can make and then implement them.

Our non clinical colleagues are vital to supporting us clinicians to do our job and not have to worry about the latest bullshit coming from the govt. we can concentrate on the patients in the clinics and wards we have to deal with that day, not how we are going to improve the health of the entire population.

I could not do my job as a consultant without the many managers and administrators within the hospital. Just dealing with the media requests and MP letters my dept receives would take up at least 2 days a week. Then there are the patient queries, the complaints and whinges as well as the real ones where there was a risk to patient safety which requires an investigation led by, you guessed it, a non clinician.

I see many nurses and lower band administrators who don't actually understand how our hospital works and that they are part of a bigger, multi disciplinary team. There is too much them and us within the lower bands but, to put it bluntly, it is because they don't understand and can't be arsed to understand the roles of other people better. I mean that's all good if that's what they want, but it makes them look stupid to their colleagues who do get the bigger picture.

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.

The more polite version of what I was trying to say.

Ditch the NHS and bring in the private insurance companies and see a massive increase in admin and management 🤣👏

You see this everywhere. I was an HCA for a while and some HCAs would complain about nurses simply doing paperwork all the time. They were not doing paperwork all the time, but there is paperwork that does need to be done that is the nurses responsibility.

I honestly don't think most people know how much shit the middle and senior managers keep fro the doors of clinicians!!

I do and thank you.

Yep. Most private insurance country health schemes have up to 10% of the staff working on simply dealing with the insurance. Selling insurance policies, dealing with claims, collecting money including excesses/copays, and dealing with complaints and fraud.
If we kept the NHS as it is and sold insurance policies to access it, we would have to increase the staff numbers by about 10%.

YANBU at all. I work in oncology and one of our ‘business managers’ was making decisions without any knowledge or understanding of the clinical roles. And getting paid shitloads.

glad she has moved on now

So as someone who works in oncology, can you explain why each of the roles the OP listed are pointless and could be done away with?
Because that's the issue here. Lay people not understanding the part that these play in the bigger picture and making assumptions about their value.

I'm a Project/Programme Manager in local government and If I "got off the bus" much like Handsan, then my organisation would be in a mess.

I'm working on several projects (not ideal) all of which will save the authority a lot of money.

I completely understand where you're coming from though - it does sound like a busy doing nothing role, but it couldn't be further from the truth.

So far the projects I've worked on in 2023/2024 are saving the authority in excess of £1.5m; we're on track to save £5m by 2027 and that's just my service area. If I didn't do it, the savings would be a lot less - Consultant PM's cost a bloody fortune.

https://www.england.nhs.uk/commissioning/

https://www.england.nhs.uk/gp/investment/gp-contract/

https://www.england.nhs.uk/digitaltechnology/nhs-federated-data-platform/procurement/

https://digital.nhs.uk/

I think a few on this thread need some bedtime reading

In my experience the people who say that aren't doing half their job properly!

Re the spreadsheet for hand sanitisers, we tried something similar years ago for something that was only used by clinicians. We (the nurses and doctors) all said yes, of course we will update it every time we used one of our stock. Reality - we were useless. We either forgot, did it wrong or needed an hour of our ward admins time to remind us how excel worked each time we went to update it.

Bottom line, most clinicians make crap administrators and even crapper managers. Some of us have self awareness to actually recognise that.

I wouldn’t have a clue what those roles entail

Agree with this! I used to work in a customer facing role and would often hear other staff complaining about head office staff. There was a us and them attitude and my colleagues used to make jokes about head office staff spinning on chairs or day or 'working' from home.

Then I got a role in head office I was all ready to for some chair spinning . Safe to say it's the busiest over worked role I have ever done.

Monthly meetings that accomplish nothing, but just role over to the next meeting where it is yet again talked about. I took and typed minutes for some the most boring. Every month same things used to be discussed. I used to just shake my head.
I always used to say if you carried a clip board or a folder and wore a lanyard you could walk around the hospital all day and no one would query who you were or why you were there.🤐

The pain manager was a clinician. They may have had offensively shiny shoes and failed to communicate with the surgeon, but they were not non-clinical staff.

Managers may be admin and clerical or may be part of any other staff group. My line manager is a healthcare professional with management responsibilities.

I think it needed spelling out, to be honest.

OP couldn't agree with you more. I left after just a few years before I was taken hostage by the excellent pension. Glad I did. Waste of taxpayer's money and some soul destroying roles

I worked in the NHS for years doing admin and was always busy, sometimes very overworked. I haven't seen any jobs with not much to do - I think they must be rare.

I mostly did jobs that were directly involved with patients. I'm sure everyone would agree that someone needs to answer phones to patient queries about appointments etc. and type letters to GPs about treatment from the hospital.

I also worked in PR when we organised VIP visits, including the PM and The Queen, which were a great morale booster. We produced patient information leaflets and screened press enquiries which would have wasted a lot of department time without us. A lot of jobs are needed but you need to understand what they really do.