To think the NHS Significant job losses are a good thing to get rid of management pushing paper around all day and increase the number of hands on staff

[Husbandrippedmeoff]

What does this mean, will they be slashing the number of people who work in management?

Do you work for the NHS are you worried?

Come do the job, then tell me how stress free it is

When the consultants P.A has a P.A that is paid more than a nurse with 20 years experience you know the NHS needs a clear out.

Yes!

None of those people work for NHSE.

Tell the doctors they should be doing their admin then and booking appointments, typing their 9an letters and managing the hospital as well as treating patients.

Dare you. I’ll watch.

I am a senior manager in the NHS and struggle to keep up with my workload. It's a myth that the NHS is overrun by managers there are days when there are so few it's unsafe (at least in my area of work). Remember the NHS doesn't just cover hospitals, it's ambulance services and remote areas where a manager can be responsible for vast geographical areas. It's a complex and massive organisation trying to make ends meet, scrutinised by CQC as well as lots of other governance. Whilst many people just think of doctors and nurses it's so much more than that and gone are the days when doctors managed hospitals and everyone rugged their forelock. Managing people is a skill, some will disagree with that, usually non managers who don't like being managed but it is.

Please can you give a specific and detailed example of this. If you are talking about a medical consultant i.e. a senior doctor, if they still have a secretary, they are likely to be a Band 4, perhaps a Band 5 if they manage a surgical waiting list but this is unsual. A nurse with 20 years experience would most likely be a Band 6 but at the very least they would be top of Band 5. A consultant's PA having a PA (assuming you mean a Personal Assistant) is Not A Thing.
If you are talking about a management consultant than there is a separate conversation to be had about the use of consultancies within the NHS - however, there is no such thing as a Management Consultant directly employed by the NHS, who has a Peronal Assistant, who in turn has a Personal Assistant of their own.

None of these people exist...

Should have said when I quoted, that I agree totally with your post. It's a national.sport bashing managers because apparently you can't be true NHS unless you're clinical.

Haha nah, if that was all it took to discourage me I'd have quit long ago, you learn quite quickly when you become an NHS manager that most people think you're a pen pusher, bean counter, clipboard wanker or other similar insults, thick skin def a part of the person spec!

It's a bit discouraging that so few people know quite how bad the facilities issue is, certainly our chief exec is out there flogging himself anywhere and everywhere that will listen, popping up on local and national news as often as he possibly can trying to spread the word (possibly outing myself but we had a big item on BBC a while back about one of our departments that was flooded and literally under water for weeks due to antiquated plumbing that leaked, thousands and thousands of pounds worth of damage done). I think despite best efforts most people out there in the general public or even in government either think we're just moaning about ugly old buildings or dark, dingy hospital corridors or ancient uncomfortable staff rooms or whatever (I mean don't get me wrong, those things would be nice to fix too, my office is looking pretty ropey right now, very dubious stained carpet that may have been there since Victorian times when it was built, but quite rightly that's absolute rock bottom on the priority list for a fix) OR they look at how much a new hospital costs and think that building 50 or 100 of them is just unimaginably, unaffordabley expensive, which is very true, but sadly we're spending that much every year in maintenance bills and lost productivity patching up the old buildings, to say nothing of the horrible patient and staff experience...

If anyone wants to actually educate themselves a bit more on what has happened so far in relation to NHS England and what's likely to come next, this is a good read.
https://www.kingsfund.org.uk/insight-and-analysis/blogs/reshaping-nhs-national-bodies-started-finish

Band 5 PAs manage large teams quite often and have a huge amount of responsibility. They dont just do PA work for a consultant, and if they do then the role is being extremely badly managed.

A nurse with 20 years experience is paid at the band they are qualified at, same as one with 10 years experience, the years experience are irrelevant to AFC pay grades other than the incremental points.

I am not really sure why this means the NHS needs a clear out specifically, if the PA is rubbish and not doing a role worthy of their pay grade then that is a different thing all together of course.

If there is a need to restructure then fine, i definitely don't disagree, my trust have just been through a huge one with lots of high grade managers both clinical and non losing their jobs, but picking on PAs, admin etc seems odd. I work in finance for NHS, our roles are way more demanding than 20 years ago and it seems that they have managed to downgrade people over time, I regularly work 60 hrs a week now, that used to be unheard pf. Everyone does their bit and I think comparing to clinical staff does no one any favours, they are different roles with different criteria. In an ideal world would it be great to pay nurses way more, of course, but actually to do my job you need to have a masters degree equivalent and lots of experience so I dont think I should be paid less than someone else just because I am not clinical. If you ask the clinical managers how much they value people in my role admin/PAs or people in contracts for example you would probably be surprised at their answers.

@MyKingdomforaNewUsername it’s not the work that is stressful, it’s often bullies that are allowed to move around the NHS that never get sacked that makes it stressful.

Please do tell us what on earth you're talking about. Consultants don't have personal assistants anymore, they don't even have their own secretary these days, or do you mean (whisper it) physician's associate? But they don't have PAs either? We can argue whether nurses are underpaid (personally I think they absolutely are) but please don't spread silly misinformation like this on an already goady thread.

@ERthree a consultant's PA would be a band 4, and they would not have just that one consultant under their umbrella. I'm a band 4 PA - technically I have three people to support but in practice I also do PA support for the service managers who sit under my general manager - a total of 11 people. In addition to that, I do data analysis and reporting, because our Information workforce has been gutted by cuts, we need the data and I have the skill set.

If a nurse of 20 years' experience isn't on a band 6 or higher, you have to ask why not.

ETA: if the NHS does not have enough admin, what happens is that clinicians have to do the admin. Which is not good for the services or patients.

Yes, but they are also providing essential services, removing which will affect the NHS, which in turn will affect how all of us are doing our jobs.

@NoctuaAthene of course consultants have secretaries! Often the secretaries look after more than one consultant in a department though but definitely they do have secretaries!

Exactly this. Structure now most likely to be something like - big team of doctors, possibly senior nurses and other AHPs too, Band 5 admin person in charge of (vanishingly small) admin team looking after that team of doctors - managing all clinic correspondence, appointment booking, trouble shooting, dealing with patient queries, possibly booking theatre lists. Plus line management of team - sickness, performance, appraisals, rostering. Probably also stuff like managing room bookings for clinics, kit requirements etc. etc. etc.
Each consultant having their own PA is incredibly rare now. (And those PAs would never and have never had their own PAs.)

Is this a joke?! Admin staff are on band 2 or 3 salaries. They’re crap salaries.

In my dept the admin staff are heroes. They get constant crap from the public for the clinics running late and spend all day apologising and fire fighting.

We used to have 4 full time admin. Now we have 1 person who does 24 hrs a week & another who does 18hrs a week. It’s not enough. It’s awful. we are missing things and soon we will reach critical mass and a catastrophic error will occur.

No one is getting rich doing NHS admin.

Yes, I know. A secretary isn't a PA though - splitting hairs maybe but a secretary as you know does way more than just assisting one person, these days they operate more as pooled admin support for a whole department. Plus they'd be Band 4 as a medical secretary. In our trust only directors have true 'PA's, as in a personal assistant (of course others have some form of admin assistant), and they're usually Band 5 and may manage wider admin teams or have extra responsibilities. So I'm trying to understand what that poster means, the implication is a consultant has a personal assistant who themselves has a personal assistant which just sounds bonkers before you get into the pay implications of the junior assistant somehow earning more than top of Band 5 which is the absolute minimum a nurse with 20 years service would be on...

100%.

Very few people now have their own PA, it is putting a HUGE amount of pressure on clinical staff.

I think what @NoctuaAthene is saying is that these roles are not really PA roles anymore and it is very unusual that each consultant in a medical team has their own secretary/PA, they are more likely to be shared.

I'm (just about!) old enough to remember the good old days before all this management malarkey started 😂and consultants did have their own personal secretary who just looked after them and they could swan in a couple of times a week, take a quick glance at their ward patients, imperiously issue orders to their junior doc firm, flirt with a few duly subservient nurses, then see a couple of patients in clinic before swanning off again and leaving the secretary to sort all the paperwork and letters and appointments out, oh and book them a table for dinner tonight and sort out some flowers for the wife while they're at it. Those were the days, everyone happy, no waste, narry a clipboard in sight, oh wait...

It’s like you typed the words right out of my head

Maybe not slash the management too much, but certainly employ better quality management and give them better training. Most of the problems in the NHS is managing the finances badly, which comes down to management at the top. Judging by the current state of the NHS it's incompetent management creating a moneypit, where, however many pounds is poured into it, is not hitting the right areas.