Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

195 replies

Husbandrippedmeoff · 16/03/2025 11:56

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?

OP posts:
notatinydancer · 16/03/2025 17:51

ERthree · 16/03/2025 16:52

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.

NHSE is different to NHS.

Livelovebehappy · 16/03/2025 17:53

Rewis · 16/03/2025 15:36

When I'm feeling stressed about my job tomorrow, I'll be sure to think of this and just not feel stressed.

But you're not off sick are you, with stress? We all get stressed in our job to a point. If the stress is too much for you, then maybe find another job which has lower stress levels. No-one is forced to stay in a low paid job if they can't cope. Lots of other jobs out there.

Livelovebehappy · 16/03/2025 17:55

Itsalljustinmyhead · 16/03/2025 16:18

To everyone saying YANBU I hope you’re not the kind of person who howls in outrage when things like diversity and inclusion aren’t considered, or when safeguarding checks aren’t carried out, or when health and safety misses something very crucial, or when an impact assessment is deemed not necessary. On one hand you all hate management, but on the other actually rely on all the things they do.

But clearly they're not doing these tasks well are they?.....

MounjaroNewb · 16/03/2025 18:28

Livelovebehappy · 16/03/2025 17:53

But you're not off sick are you, with stress? We all get stressed in our job to a point. If the stress is too much for you, then maybe find another job which has lower stress levels. No-one is forced to stay in a low paid job if they can't cope. Lots of other jobs out there.

Or....and here's a novel idea.....we staff our NHS properly so as not to put so much stress on people. Not just keep overloading everyone until they break or leave

stclementine · 16/03/2025 18:38

Husbandrippedmeoff · 16/03/2025 16:01

That is what they are called, I didn't make the phase up. If you google "NHS pen pushers" there are literally thousands of hits.

it may come as a surprise to you that pen pusher is not my job title, nor appear in my job description.

ACynicalDad · 16/03/2025 18:46

The risk is doctors end up doing paperwork when they should be seeing patients, we need a better system and more computerisation, but I doubt we have way too many administrators, some may be in the wrong places though.

Motnight · 16/03/2025 18:56

ERthree · 16/03/2025 16:52

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.

But the Consultant' PA's PA is not a NHSE employee

Livelovebehappy · 16/03/2025 19:45

MounjaroNewb · 16/03/2025 18:28

Or....and here's a novel idea.....we staff our NHS properly so as not to put so much stress on people. Not just keep overloading everyone until they break or leave

Or maybe the upper management need to organise the staff they have better. It’s just totally disorganised. We have a relative who is currently subject to a lot of inpatient appointments, and the system seems to be in utter chaos. Different areas of the NHS just don’t appear to share information between each other. And it doesn’t instil confidence when consultants are looking at out of date inaccurate notes, and are asking the actual patient for summaries of what the current status of their treatment/next steps are.

UniversalTruth · 16/03/2025 20:07

Livelovebehappy · 16/03/2025 17:48

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.

How are you deciding this @Livelovebehappy?

What if the costs of providing healthcare to the number of older people we have now, costs this amount of money. Lots of analyses have said that the NHS doesn't waste money on eg. Admin staff, is good value for money compared with other countries and the price of medication in this country is driven to very good value by the system (a system supported by NHSE).

Counter opinion: The NHS is not wasting money, it costs what it costs to provide the health service we have. If the government need to stop spending money on the NHS then they need to define what can be afforded to be provided for free to the population and what cannot. Population health and population mental health need more money. Training of health professionals needs to be joined up and junior doctors need better working conditions to stop them all leaving. Primary care needs investment or change.

But the government create smoke and mirrors of decision making by getting rid of NHSE without a viable plan for what happens next.

RawBloomers · 16/03/2025 22:17

Husbandrippedmeoff · 16/03/2025 15:40

Sorry what?

Your OP is ignorant, goady shit, so having a go at someone else for posting something you don’t find useful is V. unreasonable of you.

RawBloomers · 16/03/2025 22:19

Husbandrippedmeoff · 16/03/2025 16:21

If health and safety are missing something crucial, then there are big problems, and the current management is not fit for purpose.

Edited

Ensuring health and safety in an ever changing environment (which health care needs to be to be any good) needs constant attention.

APATEKPHILLIPEWATCH · 16/03/2025 22:21

Trovindia · 16/03/2025 12:03

Absolutely no one is "pushing paper around all day" whether in the NHS or NHSE (I suspect you don't know the difference).

A huge organisation like the NHS needs oversight and accountability, and we need people doing that. You can't just put everyone in front line jobs with no management or strategy.

YABVU

I’ve worked in the NHS. Paper pushers are most definitely a thing

Husbandrippedmeoff · 17/03/2025 00:42

stclementine · 16/03/2025 18:38

it may come as a surprise to you that pen pusher is not my job title, nor appear in my job description.

Feel free to enlighten us and tell us what you do!

OP posts:
Husbandrippedmeoff · 17/03/2025 00:44

APATEKPHILLIPEWATCH · 16/03/2025 22:21

I’ve worked in the NHS. Paper pushers are most definitely a thing

As is the case anywhere but NHS workers seem to not be able to admit it. Its as if they get a free pass to say "I work for the NHS" and we should all stand on our doorsteps and clap them.

OP posts:
APATEKPHILLIPEWATCH · 17/03/2025 00:46

Husbandrippedmeoff · 17/03/2025 00:44

As is the case anywhere but NHS workers seem to not be able to admit it. Its as if they get a free pass to say "I work for the NHS" and we should all stand on our doorsteps and clap them.

The biggest “I’m a key worker” shouter i know in lockdown was a £35k a year “Staff wellbeing officer” who organised yoga sessions and fruit and veg discounts for staff.

Husbandrippedmeoff · 17/03/2025 00:53

APATEKPHILLIPEWATCH · 17/03/2025 00:46

The biggest “I’m a key worker” shouter i know in lockdown was a £35k a year “Staff wellbeing officer” who organised yoga sessions and fruit and veg discounts for staff.

This does not surprise me at all!

OP posts:
endofthelinefinally · 17/03/2025 01:30

NoctuaAthene · 16/03/2025 16:26

I know it wasn't my post but as an NHS manager if I may chime in, I completely concur that simply throwing more staff at the NHS won't fix the problem, IIRC we actually already employ more clinical staff than ever before but obviously problems are still there. If I had a lot of money to spend to improve things I personally would, in no particular order:

  1. Fix the physical space, so many hospitals mine included are struggling uphill against multi-million pound annual maintenance bills and endless facilities issues and constraints in knackered Victorian buildings, not talking paint flaking off the walls/tired decor here, it's whole wards being closed on a regular basis because there's sewage pouring out of the ceiling or no heating in the middle of winter. And then you wonder why there's no beds and A&E is backed up. The cancellation of the new hospitals programme such a gut punch to hospitals like mine.
  1. Sort the education system out, if we could it needs a wholesale overview, we have high class undergrads nurses and AHPs graduating with no jobs to go to, post-grad doctors oversubscribed into certain specialties and others mysteriously unable to fill positions, trusts don't find out who they're getting or more often not getting into resident doctor rotas until weeks before leaving managers (yes!) scrambling to get any old person into the shifts or begging the existing docs to cover.
  1. Care sector relevant, I think we do need to invest into having much more flexible capacity both in the care home and at home care sector with everything that goes with it, social work, OTs, district nurses to get the medically optimised elderly back out of hospital quickly and also ideally to keep them out of hospital in the first place by preventing falls, treating infections early etc etc. I don't know enough about the care sector really to know if it's simply lack of staff but I suspect again it's complex and multi-factorial.
  1. Preventative medicine, as we age as a population and also live for longer with chronic and complex illnesses we simply can't carry on with a model where we wait for people to get seriously ill then treat them in hospital. Primarily thinking of the elderly here but also mental health etc. This is so hard because it needs joined up thinking and investment in the 'unsexy' parts of the system like housing, at home care, IAPT, welfare/benefits and not into exciting visible things like hospitals (I say that as a hospital manager who naturally is going to fight for as much funding and attention for exciting things like new bits of kit for the hospital which of course people tend to prefer to see money spent on over something like providing physio for long term jobless or supported housing for patients with moderate mental health problems).

There's loads more like digital, workforce review, safety and incident response, efficiency,. sustainability but those are what I would personally wave a magic wand to fix...

Edited

I agree with everything you say, especially regarding preventative medicine. I had lots of lectures about preventative medicine in the 70s when doing my nursing training. We still aren't doing it. We are still dealing with chronic illness and disability because we aren't doing it. Especially with women's health.
After nearly 40 years of extremely hard work in the nhs, I am now a patient with chronic disease, pain and disability having had to fight and beg for every little bit of health care. All too little too late. It is exhausting and frustrating.

Coolasfeck · 17/03/2025 04:31

Husbandrippedmeoff · 17/03/2025 00:53

This does not surprise me at all!

I’m embarrassed for you OP. Starting a thread with such a strong title about a subject you appear to be extremely ignorant about. Hoping people lose their jobs.

Now you’re keen to believe someone has a FT job in the NHS organising yoga and fruit discounts.

If I were you I’d just let the thread die off before making anymore of a spiteful fool of myself.

Catsonskis · 17/03/2025 06:20

NoctuaAthene · 16/03/2025 12:20

It's NHS England that is being abolished, not the whole concept of managers in the NHS. As has been extensively hashed over on here, in any large organisation such as a hospital a certain amount of management has to happen, to keep the lights on, pay the bills, manage supplies, keep an eye on the money, ensure the organisation is compliant with the law, fix the PCs when they break, arrange essential training for the staff, make sure health and safety issues get fixed and so on. It's only ever in relation to the NHS do I seriously hear people suggesting that either this shouldn't happen (and so I guess the hospital just keeps working by magic I guess?) or that the front line staff should do this in addition to their regular job? Those seem bonkers to me. Now like in every single large organisation of course there is some chaff within the back office functions that could get cut alongside the essential stuff, and like with every single human (front line clinical staff included!) there are people who are super-humanly excellent at NHS management, people that are pretty good, people that are bang average, people that are lazy and crap and people that are so bad they're borderline dangerous and dragging everyone else down with them. If we could only identify and get rid of the bottom two tiers that would be excellent but incidentally you need a pretty good HR function to do that safely and fairly - another useless pen pushing set of people!

Back to your actual question, will abolishing NHS England make a difference and lead to more front line NHS staff? As a current NHS manager in a hospital (if you hadn't guessed!) I'd say yes and maybe. NHS England is a bureaucratic tier of management created by the tories to be between actual care-delivering organisations like hospitals and GP practices and the government. Previously we had similar but there were multiple regional bodies (NHS London, NHS South West, local primary care trusts etc). In theory not a bad idea as usually you can be more efficient by centralising and creating one big organisation out of multiple smaller ones, but it hasn't really worked IMO, it's gotten bigger and more bloated over the years bringing in more and more functions and more and more divorced from the reality of being on the ground. I also think it's lacking accountability as a body. However I wouldn't be so sure we can just take the huge NHS England budget and simply just put all that back into hospitals or front line care (bit like the old misleading brexit headlines). There's a lot of boring bureaucratic NHS stuff that someone is going to have to keep doing, whether that's the department of health, local care boards or hospital managers. E.g. in the last few years NHS England absorbed Health Education England into itself, that's the function that liaises with universities and colleges about placement management for student nurses and doctors, makes sure curriculums are up to scratch and oversees postgrad training for doctors, very complicated and important stuff. Now NHS have pretty much done a crap job managing all that and HEE were poor before then too so I'm not complaining it's going to have to move again but someone has to do it and ideally centralised at at least a regional if not a national level as it would be chaos if hospitals and GPs were trying to do it. Also, overseeing GPs, managing who is allowed to set up GP practices, performance managing them and deciding how much they get paid (and then actually paying them) is another complex job. At a guess I'd be saying even if you are very ruthless about cutting the more 'managerial' end of what NHS does (efficiency initiatives, patient safety promotion, equalities stuff), at least some of which I'd also say is worthy of attention even if NHSE didn't do the best job, you'd only save maybe 30% of the NHSE budget , and even if you did put that money direct into front line care, the NHS budgets as a whole are so small I don't think you'd see a huge difference when spread around the whole of the NHS.

TLDR = yes it's a good idea to get rid of NHSE, no it won't mean many more nurses on the wards.

Long answer to a short question but I hope you see how complicated these things are!

Excellent post and summary

Catsonskis · 17/03/2025 06:29

ERthree · 16/03/2025 16:52

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.

7 NHS trusts between myself and my partner and I’ve literally never heard of this? The vast majority of PAs for consultants are a band 4 (qualified nurses start at the bottom of band 5, and if qualified for 20 years and never promoted they’d be at the top of band 5). And in my experience each PA looks after 2-4 consultants and certainly doesn’t have their own PA, what a ridiculous statement. There’s often other admin functions of a lower band that work with the consultant team such as the outpatient booking clerk or the admissions officer but usually work in different departments and are a band 3.

Toddlerteaplease · 17/03/2025 06:51

@Kpo58absolutely. To admit a party to our ward means logging on to three separate systems. One to put them on the bed state. One for stickers and one for wristbands.

Motnight · 17/03/2025 07:06

Husbandrippedmeoff · 17/03/2025 00:42

Feel free to enlighten us and tell us what you do!

Why the aggressive posts @Husbandrippedmeoff?

ByQuaintAzureWasp · 17/03/2025 09:34

NoctuaAthene · 16/03/2025 12:20

It's NHS England that is being abolished, not the whole concept of managers in the NHS. As has been extensively hashed over on here, in any large organisation such as a hospital a certain amount of management has to happen, to keep the lights on, pay the bills, manage supplies, keep an eye on the money, ensure the organisation is compliant with the law, fix the PCs when they break, arrange essential training for the staff, make sure health and safety issues get fixed and so on. It's only ever in relation to the NHS do I seriously hear people suggesting that either this shouldn't happen (and so I guess the hospital just keeps working by magic I guess?) or that the front line staff should do this in addition to their regular job? Those seem bonkers to me. Now like in every single large organisation of course there is some chaff within the back office functions that could get cut alongside the essential stuff, and like with every single human (front line clinical staff included!) there are people who are super-humanly excellent at NHS management, people that are pretty good, people that are bang average, people that are lazy and crap and people that are so bad they're borderline dangerous and dragging everyone else down with them. If we could only identify and get rid of the bottom two tiers that would be excellent but incidentally you need a pretty good HR function to do that safely and fairly - another useless pen pushing set of people!

Back to your actual question, will abolishing NHS England make a difference and lead to more front line NHS staff? As a current NHS manager in a hospital (if you hadn't guessed!) I'd say yes and maybe. NHS England is a bureaucratic tier of management created by the tories to be between actual care-delivering organisations like hospitals and GP practices and the government. Previously we had similar but there were multiple regional bodies (NHS London, NHS South West, local primary care trusts etc). In theory not a bad idea as usually you can be more efficient by centralising and creating one big organisation out of multiple smaller ones, but it hasn't really worked IMO, it's gotten bigger and more bloated over the years bringing in more and more functions and more and more divorced from the reality of being on the ground. I also think it's lacking accountability as a body. However I wouldn't be so sure we can just take the huge NHS England budget and simply just put all that back into hospitals or front line care (bit like the old misleading brexit headlines). There's a lot of boring bureaucratic NHS stuff that someone is going to have to keep doing, whether that's the department of health, local care boards or hospital managers. E.g. in the last few years NHS England absorbed Health Education England into itself, that's the function that liaises with universities and colleges about placement management for student nurses and doctors, makes sure curriculums are up to scratch and oversees postgrad training for doctors, very complicated and important stuff. Now NHS have pretty much done a crap job managing all that and HEE were poor before then too so I'm not complaining it's going to have to move again but someone has to do it and ideally centralised at at least a regional if not a national level as it would be chaos if hospitals and GPs were trying to do it. Also, overseeing GPs, managing who is allowed to set up GP practices, performance managing them and deciding how much they get paid (and then actually paying them) is another complex job. At a guess I'd be saying even if you are very ruthless about cutting the more 'managerial' end of what NHS does (efficiency initiatives, patient safety promotion, equalities stuff), at least some of which I'd also say is worthy of attention even if NHSE didn't do the best job, you'd only save maybe 30% of the NHSE budget , and even if you did put that money direct into front line care, the NHS budgets as a whole are so small I don't think you'd see a huge difference when spread around the whole of the NHS.

TLDR = yes it's a good idea to get rid of NHSE, no it won't mean many more nurses on the wards.

Long answer to a short question but I hope you see how complicated these things are!

Appreciate your words ... quite thought provoking. Thanks.

stclementine · 17/03/2025 19:02

Husbandrippedmeoff · 17/03/2025 00:42

Feel free to enlighten us and tell us what you do!

I already have. Do read your own thread.

EilonwyWithRedGoldHair · 17/03/2025 19:19

MyKingdomforaNewUsername · 16/03/2025 14:58

My admin department of 12 has 3 vacancies we aren't allowed to put out due to costs and 4 on long term sick due to work stress. The 5 of us remaining will also be off with stress soon if this carries on

This is part of the problem with the NHS. Office staff off on long term sick due to "work stress"? How stressful can admin be? Bet they'd be back soon if the sick pay wasn't so generous!

I'm voluntary sector, not NHS, but admin can absolutely be stressful - for example imagine your workload being more than doubled and only being given two extra hours a week.

We have a lot of contact with the NHS locally, at one point one of their admin staff used to pop over to use our photocopier as they weren't allowed to do colour copies because of the cost, even if it was affecting that needed to be in colour. Admin staff also ended up buying pens and stationery. She left in the end and wasn't replaced, so presumably some manager on a lot more money had to do his own admin...

Swipe left for the next trending thread