To consider working for the NHS?

[NHSMaybe]

I'll start by saying healthcare in general is really not my thing. I'm very appreciative of the NHS, but I can't 'do' blood, would never want to be a doctor/nurse (very squeamish) and have never even looked at any jobs working within the sector.

I work in a pretty niche operations role in the Tech Sector. I'm a Director - very good role with lots of perks, including lots of WFH except for when I travel every month or so. I earn approx £130k base, with a few years of incredible bonuses. On paper everything in the role is perfect, but I have the underlying constant feeling that essentially I'm not doing any 'good' - I'm just making rich people (and me!) richer.

I've been approached about an NHS role in the same niche. The role is Associate Director (band 8d, £96-109k inc a supplement for being based in central London) and I've been assured it would be hybrid and flexible. Not really scope to progress without expanding from my niche, but that is the case in my current role too!

Am I mad to be considering this? I could definitely 'survive' (very well, I appreciate I'm a higher earner!) off the lower salary, and it's actually made me feel really excited for the first time in a while about making a difference.

Also some technical questions:

• If you work in the operations/admin side of things, do you feel you have a good work/life balance? I know there's 'the NHS is on its knees!' which gets spoken about a lot, but outside of primary care is this still the case? FWIW the role is in a specialist hospital, not a general one.

• I've heard conflicting things, but would I be able to negotiate salary for further up the band due to previous experience? A friend works for the NHS and is adamant I'd only be 'allowed' to enter at the bottom of the band.

Also happy to hear general tips/considerations when thinking about working for the NHS. I know the pension scheme is pretty good! I'm very new to this and have no one to talk to about it IRL (friend who works for the NHS doesn't know much about the Operations/Admin side!)

Great pension. But your mental health will be shot.

It's so bad that I quit before I even had a new job to go to.

The pension is no longer great. Better than lots yes, but it isn’t the gold plated of yesteryear. They are slowly eroding any kind of meaningful benefit or perk of working for the NHS.

To offer a different perspective; I am relatively new to the nhs after joining sept 2023 in a non clinical manager role though lower level than director and my experience has been amazing

I am also in a Yorkshire hospital and I have genuinely enjoyed every day, I work closely with execs but as I’m in within the HR sphere also get quite involved with staff and managers across the board and I can only think of 1 person whose personality style I don’t mesh with

workwise I manage my own diary, can come/go as I please office wise and work from home as I choose. There is no micromanaging as at the level I am at I am just expected to get on and do my work and it would become clear when projects didn’t progress if I didn’t do that and I really like the autonomy I get

is there the option to go visit the Trust and get a feel for the place?

I'm an anaesthetist partner works in cybersecurity says you couldn't pay him enough to work in the nhs the IT and its staff are so bad

The IT is mind bogglingly awful and staff can be very set in their ways. It's like stepping back into an 80s work environment so if you are coming from tech you might find it very hard.

I've worked in various aspects of NHS IT nearly all my life. I moved in because it felt soulless in private sector. Stepped out briefly, missed it, came back. I've not been bullied and I find NHS workers nicer than those I worked with in private companies and HR/policies much more supportive on sickness, various leave, flexi working etc. I could earn more elsewhere but I'm proud to be where I am. I can only speak for up to B7 level but there is a lot to be said for working with people who care to help patients. What have you got to lose by trying if you are feeling a calling to do so?

Just be aware it takes time to learn the NHS, everything from finance/funding to procurement to planning to HR is different to private sector and arguably more difficult for managers, there is a big structure to learn within and across organisations, the roles and how they fit together, specialities, care settings, all the targety stuff like 18 week/two week waits and the complex rules around it all. I saw a BBC programme years ago where a well known private sector consultant came in and tried to solve problems, hit barriers at every turn- infection control, fire safety, clinical governance, information governance, there are a zillion internal police forces to stop you changing anything in a way that might cause trouble. Utterly fascinating if you enjoy well intentioned complexity. Why not enquire if you could take leave from your current job and shadow someone for a week or arrange a chat with someone in a similar role? I don't know what's possible at that level due to confidentiality but HR will want to get good people interested/in.

I actually think this role would be okay. If you can choose a role where you can make a positive impact to individual patients on a day to day basis (this role really would) then you'll get a lot of satisfaction. I love that part of my clinical role in A+E. The upper management shit is just unbearable. I just wouldn't swap a 130k job with benefits to much less pay for much harder frustrating work like OP. I'm sorry for your I'll health at the moment, it's admirable that you want to use your experience to make it better for others.

I worked as a Local Authority paediatric social worker. I loved it, having found a way to stand up to bullying by autocratic Consultants and equally bullying Senior Nurses. I got on with almost all the House men/women, the orthopaedics team and the people in psychiatry. I found that by standing up for my professional role and by being in the firm's team meetings, I was respected.
Later in my career, I moved to a highly reputable mental health hospital and found the same tactics worked better and more quickly.

No you're not mad. The pension will be excellent.

The restructure coming might mean it's short term but it sounds like you have very high demand skills.

I'd go for it if you fancy it.

Do you truthfully believe you could make a positive impact in this role? That's what I would really think about. Because that is your main reason for change and many highly paid non clinical roles in the nhs don't really have any genuine positive impact on patients at all.

Don't. If you value your sanity just don't. My DH has retired after working all his life for them. I was so glad he could, as his manager was bullied into ill health, I didn't want that to happen to him. My son works for them, and he has experienced bullying the like of which I have never seen or heard of before. Just don't

You would probably do a lot more good donating the difference in salary to a reputable charity.

Why does the NHS attract so many bullies? Is it hard to fire people?

The only place I ever worked in were the Managers got away with bullying. Didnt stay long, which was a shame as loved my job, but couldn't cope with theo the dog eat dog culture

@Foxgloverr Nigh on impossible.

What really winds me up is the relentless bleating from upper management of the “self-care” and “be kind” and “inclusive” dogma at every turn when you know they’re all just talking out their arses and none of the corporate team actually practice what they preach. It’s messy out there. Change is slow, the cliques look after their own.

I'm in ops. I wouldn't do anything else, despite all the shit I love it still but if you've not worked in the nhs before I doubt you'd enjoy it.

Why is it hard to fire people though? The same employment laws apply in the NHS and the private sector.

This. No longer any benefits or perks. They changed the "good" pension a couple of years ago or so.

I used to work for the private sector before working for the NHS. I found that they look after their employees very well I was able to see a doctor fairly quickly if I had a health problem. For example I trapped a nerve in my foot and saw someone within hours. Also their pension scheme is very good and you can freeze it or take a lump sum if you leave the NHS. I worked in 2 departments and found them interesting and I enjoyed serving the public. My other half also worked for them for over 20 years as a manager but decided to change careers but he will still get his pension at 60.

I disagree not all managers are shit. However the worse managers are doctors because they have no idea how to budget. All managers have to stick to a budget and the doctor/managers I knew always wanted to overspend. The NHS will always be on its knees and needs a radical overhaul imho

I never experienced any bullying and neither did my partner and he worked for the NHS for over 20 years as a Patients Services Manager If anyone was a bully it was senior consultants some of which had a ‘god complex’. I am speaking from my experience I worked at 2 hospitals. My partner worked at 10 hospitals up and down the UK

Ridiculously hard to fire people. Whether it's underperformance, prolifically off sick, bullying, people just don't get sacked. You usually find the bullies get promoted 🙄

IMHO (from making a similar move which caused nothing but stress and misery):

Don’t do it.
At that level (8+) it is awash with under performers who have worked in the NHS for decades and been promoted through the management grades as it is the only way for their bosses to get rid of them from a department.
COVID and the move to hybrid made things even worse.

Frontline clinicians certainly deserve our respect.

BUT the unbelievably tangled web of ‘directors’ seems to be a job creation spiral for the many lazy, talentless hangers on who will never be sacked for underperformance.

They also create ‘special projects’ when needed to make sure the level 8+ admins keep their salaries whatever restructuring or efficiency improvements are attempted.

They are unsurprisingly very protective of the system they have created hence the culture of bullying.

Just my opinion of course!

I’m guessing you’re one of the managers haha

Not one of the front line clinicians whose priority is actually delivering patient care

QED

I’m a civil servant and I love being one, but in your situation I absolutely wouldn’t. I don’t know much about the NHS but in my dept (and I am quite confident to say all) the red tape and slow pace things move is so frustrating. Especially tech. A colleague who joined last year from the private sector said she thought she had gone back to the dinosaur era!