NHS staff cuts

[HamptonCourtPrincess]

Well, this is going to go down well with NHS staff. In an already understaffed NHS they decide to go ahead with loads of job cuts. Ok, maybe just management but, seriously! Those left will pick up extra work. As someone who has worked in the NHS for almost 30 years, I am fed up of the constant cost cutting, yet they still expect a high quality service. Many of us are already doing the jobs of more than one person (and taking on the extra stresses). Many departments are understaffed.

My manager told us yesterday that we’d saved ‘x’ amount of money, as a department, over the last year. So, our budget for next year has been cut - to less than what we’d spent (even though we’d managed to save money). We can’t recruit any extra staff so desperately needed. Staff go off sick because they end up doing too much. Quality deteriorates as people rush.

But yet, our country seems to have plenty of money available for other things…

I am seriously fed up of working in the NHS.

The computer system.
the computer system
the computer system
the nurse on the ward can book them onto the ward
notes are electronic

🤷‍♀️

im not saying it’s good or it will work but that’s the route we’re going down.

The NHS has been doing so for years. How far can you go before the quality of your service deteriorates…

Have to say, as a band 7, our band 8’s work bloody hard. They do a lot that others don’t see and take on a lot of the pressure. A lot of frontline staff don’t understand what their role requires.

I worked as a band 6 for most of my career and used to think the band 7’s and 8’s didn’t do a lot. Boy, was I wrong!

As far as I understand they are not cutting front line but quango roles that don’t need doing? Allowing extra money to be put into front line services

I work in one of the organisations that this announcement refers to. We are losing 50% of our staff. My role is to manage the commissioning and payment of nursing home places for patients who are discharged from hospital. When that slows down or stops because our team is halved we will have patients taking longer for discharge, nursing homes not getting paid on time hence not being able to pay their staff. We already pay too much for these placements but don’t have the time or the staff with skills to do the right analysis work and decision making to put better systems in place which would save money.

The systems for making payments are abysmal and my team often spot mistakes which are rectified before payments get made. With less staff these incorrect payments will go through unnoticed. I save significantly more than my salary every year.
When we are gone the costs of this area will increase because all we will have the resources to do is pay what the homes are asking for and we won’t have the resources to do as many checks.

But hey ho @ForCraftyWriterdon’t worry I really am a waste of money and not needed according to most people in this country. The votes of people who don’t understand what we do are more important to labour than the management processes we operate.

My salary is miniscule in comparison to the amount of money I save. My teams budget is £500m so any errors/ overpayments/ payments for patients who have sadly RIP will mount up and ultimately affect money available elsewhere.

What we really need is a thorough redesign of our way of working and yes that would cut the number of managers needed and save money through the operation of a more efficient process. However senior management (and there are too many of them) don’t have the decision making skills to do this. Instead they bring in external consultants who come in for short periods, cause chaos, waste time and money, sign us up for ridiculous private sector contracts which they think will help but don’t stick around long enough to see the results.

This process we are now in is working the wrong way round and is cutting staff before changing the system. No one knows who should stay and who needs to go because we don’t know what our organisation will look like or have responsibility for in 6 months time. We will lose the best staff who can walk into jobs elsewhere and will be left trying to fit the poor over worked, demoralised staff left into a new structure.

This is about NHS England and ICBs, not individual hospital trust level.

Having said that most NHS Trusts are running VR schemes on a rolling basis and where I work our admin posts are being scrutinised with a view to downbanding. Admin is too highly banded where I work (they’ve got away with putting administrators on 2 pay bands above what most of the country pays). Whereas registered clinical staff are held down in low banded roles.

There should be majority cuts at bloated corporate level (which is what Trusts were instructed to do) but I can’t see that happening as the axe rarely swings up does it?

Maybe, in about 50 years time....

50 years ago would have been thought nuts to predict the technology of today. And progress is exponential.

Until AI can get up off a desk and have conversations/inspections in specific environments that the public can't access and technology can't enter, build relationships and negotiate with the egos of partner organisations, I think I'm probably safe until I retire at least!!

I've been clinical and a manager, then senior manager in the NHS. There are management roles within the NHS that can be discarded with minimal impact on services. The last trust I worked in (a community trust) had ridiculous numbers of non-clinical manager grades, and created more, often at a higher band so someone could slide into that role whilst someone else filled their previous role. When 'transformations' were undertaken, no-one senior was ever made redundant, they were moved into newly created roles instead. I've got friends who really aren't busy on band 8A, no service would suffer if their roles ceased to exist.

How was your role performed before NHS England existed? It sounds essential and like it would always have been essential

Fully agree. I have friends, ex colleagues on band 7 and 8 in a niche transformation project which has been running over 5 years with no tangible changes. Waste of money

@ForCraftyWriter I am not from NHS E but work for an ICB, previously a CCG and I think a PCT before that. Yes it is essential as are many managers jobs although better systems and processes would help to reduce head count.

This is such an old trope that has been disproven so many times.

All the b8as I work with, me included do multiple roles due to vacancy freezes, but the work doesn’t stop. There is a team that has 6 people off due to stress and the work still has to be done with less staff. I work above my hours but don’t get overtime as that was banned.

as said before I am considered corporate and under review. There are quite a few of my work streams that can be automated, but we don’t have the staff to do it version me to do it. Plus our trust not wanting to spend the money for the software to do it, which would be cheaper than us manually do it. This would then free up time for us to be able to do our work in the time allowed and not need to employ the people.

as someone said above we need new ways of working and then see what staff is needed. But with the nhsE and ICB reducing in size we also can’t get our funding freed up or commitments for forecasting.

It’s messed up and no thoughts has happened. doing it way they are will cause a more dysfunctional nhs. I agree there is streamlining and new modern ways of working needed, but plan it properly.

I am guessing that you are not aware that most NHS Managers are actually senior Clinicians who have their clinical caseloads, but also manage more junior staff.

No. The press tells you that. Actual research tells you the NHS doesn’t have enough managers….

Governments across the divide have cut costs for years. They complain about waiting lists, and say they’re desperate to lower them. They also know quite well that people will wait longer, because they are stripping money out of the system. They’re a bunch of hypocrites. Also, I’m utterly sick of staff and services being blamed endlessly for inefficiency, often by those who use it as a cover to save money. Helped along by certain media organisations. It’s all bullshit.

The government could start by simplifying the patient records systems (System One, Rio etc). Recording the most simple piece of information eats up clinical time on a massive scale. One easy to use system across the UK and across health and social care would free up time for everyone. That’s my two penneth.

Never going to happen. Tried so many times over the years. Too many self interested parties and departmental idiosyncrasies.

Patient held records would be the way to go, but apparently we are not to be trusted.

@StrikeForever

Thats not the case in my trust.