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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:
Trovindia · 04/04/2025 15:18

crockofshite · 04/04/2025 14:51

Actually I work for an NHS ICB and can absolutely confirm there's a shed load of paper being pushed around and around , dozens of pointless recurring meetings that simply regurgitate the same verbal diahhrea every month , pointless admin tasks that will never result in anything useful. NHS management is a dinosaur and could be culled without any affect on patients.

ICBs are not generally what people are referring to when they talk about NHSE though, and you are then taking about NHS management as if they are the same, which is part of the problem on this thread. NHS and NHSE are separate. And NHSE regional and national teams do really important work holding ICBs and trusts to account.

NoctuaAthene · 04/04/2025 16:55

OFHelp · 04/04/2025 08:54

Yes so that does seem to replicate what she said about them retaining the higher bands who hold the clinical skills or expertise and the less skilled lower bands (I.e admin) will not be seen as crucial moving forwards

The link that poster gave is about ICBs though, which is different to NHS England which is what the thread (started of as) about and different again to hospitals and hospital management which is what many people are now talking about. I'm also not sure people working in Comms, regulation, performance etc are what most people would describe as low banding or 'admin', not clinical maybe but then most people working in ICBs are not clinical. Most people that work in ICBs are in specialist corporate roles IME, Band 7+ and these will be the people most at risk of job loss in the next 6 months as this now seems to be where the quickest cuts are coming.

It's also my understanding that the rationale for cutting the functions you mention is in an attempt to reduce duplication between ICBs and provider/hospital trusts on the one hand and ICBs and NHSE on the other. I can sort of see the rationale for that, we do attend quite a lot of meetings with the ICB where we have to give a lot of updates and reports 'for assurance' with no real action taken (often the same or irritatingly close but not-quite-the-same as we have to do for NHSE), and I can see some duplication of effort on things like patient comms, very important of course but does it need to be done twice over or is that actually worse than doing it once and well? As a hospital manager I'm of course happy on a selfish level we seem to be a tiny bit more protected but being more cynical I'm not sure on what basis it's been decided it should be the ICB end that gets cut not the trusts, other than the fact it's not a good look politically to be cutting hospitals (well except they are cutting hospitals too but that's another thread). My other concern it that's it's fine to say we don't need 2 tiers of management in between trusts and the government but if we cut both NHSE and ICBs back totally, I'm not convinced chaos won't completely reign, plus I feel very sorry for my ICB colleagues who aren't to blame for the stupidity of the system around them...

SErunner · 04/04/2025 16:58

The NHS is one of the most undermanaged healthcare systems in the world. Arguably it possibly needs more management than less. Effective management leads to effective systems and services. Managers can’t be effective when they are under-resources, in the same way clinicians can’t. The axing managers narrative is popular with the public though, hence why it gets fed by politicians and the press.

crockofshite · 06/04/2025 18:10

Trovindia · 04/04/2025 15:18

ICBs are not generally what people are referring to when they talk about NHSE though, and you are then taking about NHS management as if they are the same, which is part of the problem on this thread. NHS and NHSE are separate. And NHSE regional and national teams do really important work holding ICBs and trusts to account.

NHS ICB drones report to NHSE drones who report to Dept of Health drones
And if you work anywhere in this quagmire you know how slowly the wheels grind, and how often the slowly grinding wheels shudder to a halt in a cull de sac without reverse gear. And 1-2 years later the whole process starts again, IE the next 'pilot' .....

crockofshite · 06/04/2025 18:40

SErunner · 04/04/2025 16:58

The NHS is one of the most undermanaged healthcare systems in the world. Arguably it possibly needs more management than less. Effective management leads to effective systems and services. Managers can’t be effective when they are under-resources, in the same way clinicians can’t. The axing managers narrative is popular with the public though, hence why it gets fed by politicians and the press.

There's no point having layers and layers of management between ICBs and NHSE and DoH etc if there's no money in the pot. They're all (ok most of them) redundant.

Trovindia · 06/04/2025 21:42

crockofshite · 06/04/2025 18:10

NHS ICB drones report to NHSE drones who report to Dept of Health drones
And if you work anywhere in this quagmire you know how slowly the wheels grind, and how often the slowly grinding wheels shudder to a halt in a cull de sac without reverse gear. And 1-2 years later the whole process starts again, IE the next 'pilot' .....

There's also lots of great work happening and good projects being completed.

crockofshite · 07/04/2025 11:15

Trovindia · 06/04/2025 21:42

There's also lots of great work happening and good projects being completed.

Veeeerrrry slooooowly

Trovindia · 08/04/2025 14:22

crockofshite · 07/04/2025 11:15

Veeeerrrry slooooowly

Not always, but it's clear you are determined to be negative and not listen.

crockofshite · 08/04/2025 15:17

Trovindia · 08/04/2025 14:22

Not always, but it's clear you are determined to be negative and not listen.

Well I'm veering on the side of negativity as that's the reality.

Icebreakhell · 09/04/2025 08:04

NHS Trusts were instructed to implement a 50% cut to corporate functions such as HR, estates, non patient facing nurses.

Instead, NHS trusts seem to be freezing and scrutinising all vacancies, inc frontline clinical staff. This is being led by the people whose jobs should be the ones being let go.

The axe never swings up does it?

planthelpadvice · 09/04/2025 08:14

I think trusts were told to cut the growth in corporate roles by 50%, which is slightly different.

TeenLifeMum · 09/04/2025 08:20

I work in comms so we’re supposed to reduce numbers. We’re looking at changing services significantly but apparently comms isn’t important so I guess we will make changes and just not worry about explaining it to the public or consulting on it (key role of icb comms). We also do everything on a shoestring as we have historically always had the tiniest budgets compared to other corporate functions so I’m not sure we’re the team to find massive savings.

I did find a spend to save initiative that would cost less than £30k to implement but save £50k each year, likely more but that was all I could evidence. We can’t implement it due to team capacity. Just means we cannot modernise as we don’t have the people to do it.

planthelpadvice · 09/04/2025 08:23

TeenLifeMum · 09/04/2025 08:20

I work in comms so we’re supposed to reduce numbers. We’re looking at changing services significantly but apparently comms isn’t important so I guess we will make changes and just not worry about explaining it to the public or consulting on it (key role of icb comms). We also do everything on a shoestring as we have historically always had the tiniest budgets compared to other corporate functions so I’m not sure we’re the team to find massive savings.

I did find a spend to save initiative that would cost less than £30k to implement but save £50k each year, likely more but that was all I could evidence. We can’t implement it due to team capacity. Just means we cannot modernise as we don’t have the people to do it.

Edited

I hear you!!

Govt: Lets make loads of changes to the NHS and tell patients and the public that they can have a say on this and be involved etc.
Also govt: Comms and engagement isn't really needed.
Patients and the public: What's going on in the NHS? How can I have my say? Why haven't you consulted us?
Govt: Woah, what's all this bad publicity. Why haven't Comms down something....?

TeenLifeMum · 09/04/2025 08:26

planthelpadvice · 09/04/2025 08:23

I hear you!!

Govt: Lets make loads of changes to the NHS and tell patients and the public that they can have a say on this and be involved etc.
Also govt: Comms and engagement isn't really needed.
Patients and the public: What's going on in the NHS? How can I have my say? Why haven't you consulted us?
Govt: Woah, what's all this bad publicity. Why haven't Comms down something....?

YES! Exactly this!

Motnight · 09/04/2025 08:58

Icebreakhell · 09/04/2025 08:04

NHS Trusts were instructed to implement a 50% cut to corporate functions such as HR, estates, non patient facing nurses.

Instead, NHS trusts seem to be freezing and scrutinising all vacancies, inc frontline clinical staff. This is being led by the people whose jobs should be the ones being let go.

The axe never swings up does it?

The senior leaders in NHSE have in the vast majority already left, no doubt with huge financial packages. Amanda Pritchard is going back to her old job as Chief Exec of Guys and St Thomas's. She literally got paid over £200k to leave NHSE and have a holiday before starting her new (old) role!

Scenicgirl · 09/04/2025 23:24

Motnight · 09/04/2025 08:58

The senior leaders in NHSE have in the vast majority already left, no doubt with huge financial packages. Amanda Pritchard is going back to her old job as Chief Exec of Guys and St Thomas's. She literally got paid over £200k to leave NHSE and have a holiday before starting her new (old) role!

Well, so what?
She was told in no uncertain terms that she wasn't suitable for the role so of course she should be paid to leave. The fact that she is returning to her old role means that they valued her. The majority of the people leaving will not be going on "huge packages".

Burngreave · 09/04/2025 23:34

But do managers sit around “pushing paper” all day or do they, you know, manage stuff.

The NHS is a massive behemoth of an organisation. It needs managers.

I’m not saying efficiencies can’t be found but the characterisation of anyone who isn’t clinical staff as some kind of idle do-nothing pen-pusher is also grossly unfair.

AliAtHome · 10/04/2025 00:32

Money will not be diverted to frontline/clinical roles. The NHS perse has a massive overspend and cuts are being made in an effort to reduce this - NHSE and all the NHS Integrated Care Boards (who fund and commission your local NHS services) are targeted to rightly avoid reducing clinical costs. The latter have to reduce costs by 50% by December. Having already reduced costs by 30% last year. There’s not much fat left trim and of course while implementing these cuts resources are diverted from delivering the work these organisations are meant to do (or staff expected to work the day job as well as managing the changes, redundancies etc). Am I worried. For me no - I can get another job. But for the future of the health service yes I am. I agree something radical needs to happen and I hope it works.

Motnight · 10/04/2025 07:24

Scenicgirl · 09/04/2025 23:24

Well, so what?
She was told in no uncertain terms that she wasn't suitable for the role so of course she should be paid to leave. The fact that she is returning to her old role means that they valued her. The majority of the people leaving will not be going on "huge packages".

I thought (and still think) it is an interesting piece of info @Scenicgirl. Hope that helps.

Thunderingfanjo · 10/04/2025 07:43

Our Trust has just announced a 'mutually agreed resignation' scheme for admin (bands 2-9) I'm not sure what plan B is if they don't get enough volunteers but I do know that the clinical staff cannot do their jobs and the trust will grind to a halt without the admin team.
Hospitals need a whole army to run and cutting admin roles will have a direct effect on patient care.

Scenicgirl · 10/04/2025 23:43

Thunderingfanjo · 10/04/2025 07:43

Our Trust has just announced a 'mutually agreed resignation' scheme for admin (bands 2-9) I'm not sure what plan B is if they don't get enough volunteers but I do know that the clinical staff cannot do their jobs and the trust will grind to a halt without the admin team.
Hospitals need a whole army to run and cutting admin roles will have a direct effect on patient care.

Sorry to hear that but interested to know how a "mutually agreed resignation " scheme differs from VR or is it one and the same?

DollydaydreamTheThird · 10/04/2025 23:50

Lottapianos · 16/03/2025 12:15

This tired old line about NHS managers is so dull. The NHS provides and organises healthcare for not far off seventy million people. Surprisingly enough, that takes rather a lot of 'managing'. Doctors and nurses are just the tip of the iceberg when it comes to the range of services that are provided.

Im not management, but was a clinician for a long time, now in a corporate role within the NHS. I know loads of managers and many of them are extremely dedicated, hard working, constantly up against it, and know that they and their teams are seriously under valued by just about everyone, but they keep going anyway. They're certainly not shuffling paper or enjoying long lunches

This. My managers are extremely hardworking and dedicated. They deal with a lot of stressful situations and they get paid a quarter of what the clinicians do but they always put patients first. It doesn't seem right really. OP this is a very ignorant post! I wonder what you do for a job OP? You don't know what work is until you have worked in the NHS. I know because I was in the private sector for years in various roles before I worked for the NHS.

Icebreakhell · 11/04/2025 07:14

Our general managers work very hard and earn their wages.
Although it is galling that many are in their 20s and 30s earning more than senior clinical staff with 30 years of experience.

I find our hospital trust is bloated with corporate functions:
Layers of HR who seem to do f-all other than write and oversee overly complicated ‘policies’.
Layers of corporate nursing with no patient contact and whose jobs seem to exist to badger and annoy the overworked clinical staff under them.
Matrons in every department, again no patient contact.

Thunderingfanjo · 11/04/2025 07:43

Scenicgirl · 10/04/2025 23:43

Sorry to hear that but interested to know how a "mutually agreed resignation " scheme differs from VR or is it one and the same?

My understanding is that in a Redundancy situation it's the role that no longer exists and legally they cannot recruit into that particular role for a defined period. With mutual resignation schemes I think its more of a case of saving money across the entire workforce and then roles will be redistributed between the the remaining workers depending on priorities....

Redundancy is 4 weeks salary for each years service and mutually agreed resignation is only two weeks.

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