The axe falls on the 'protected' NHS

[atlantis]

In Proposals were drawn up by the 10 English strategic health authorities for productivity and efficiency savings.

'Tens of thousands of NHS workers could be sacked and thousands of hospital beds lost.

The plans could also see procedures such as hip replacements scrapped and patients encouraged to email doctors rather than visit surgeries.

Sir David Nicholson spoke of the need to make between £15 and £20 billion in productivity efficiency savings over three years.

South East Coast region, which covers Surrey, Kent and Sussex, up to £1.6billion must be saved.

A document marked 'restricted' and circulated among SHA board members suggests 10,000 or more of the region's 100,000 NHS workers may lose their jobs

'The new financial environment demands that the trend in workforce growth must be reversed.'

It said staffing in the acute sector, covering hospitals, 'can be expected to decline faster and further' than elsewhere.

In London, which faces £5 billion in cuts, documents show managers believe up to £2 billion can be saved from community care budgets.

www.dailymail.co.uk/news/article-1261139/Labours-secret-plans-axe-tens-thousands-NHS-jobs.html

There is money wasted in all sorts of places. I agree that largely due to government imposed targets, there are probably more managers than there would otherwise be, but they are there to collect, analyse and feed back data on performance. If there was less focus on targets, you'd cut these kinds of posts. However, being an NHS manager myself, it's really upsetting that people have such a negative opinion of us and that we are all tarred with the same brush. I know that I work bloody hard to deliver a high rate frontline service in a very stressful environment and have huge respect for the clinical staff.

Trust's have been aware of 10% cuts for the next year for a couple of months now, so it's remained a mystery to me why the government has been talking about protecting NHS budgets. The extent of the cuts required over the next 3 years will not be achieved through natural wastage of staff. There is a focus on transferring care to community services, but how can this be achieved without spending more money in the short term? Where are the polyclinics - which are required to delvier services in the community - going to come from? You can't shut a hospital unit on the Friday and open a polyclinic on the Monday?

It's about time that public debate was held on the future of the NHS. I truly cannot see how putting 1000's of NHS staff out of work will benefit patients and society. If people want access to free-at-the
-point-of-use healthcare to be protected, they have to decide if they are willing to pay for it.

maxpower, I think I was the first to express a degree of negativity toward NHS management on this thread. Please don't think it was an general excuse to NHS manager bash, there are some excellent managers in the NHS. However, there are also pretty useless ones and layers where there simply doesn't need to be a layer (no matter how good).

Now obviously I wouldn't argue with Riven as she well knows. I am an NHS manager and I don't recognise these management posts you describe, I definitely want one of them because it sounds alot easier than my job.

When I worked in hospitals, we all had to take 48 hours off following D&V and I think that's a sensible thing. You are exposed to far more illness, that's part of the reason sickness rates are higher. When I worked in A&E I contracted bronchitis three times, acute conjuctivitis, developed migraines. I worked through out all that. I've had to send nurses with pleurisy home.

There have been 'efficiency savings' (i.e. cuts) for as long as I've been in the NHS. It's not new, just politics. If you want to vent, you should target the Strategic Health Authorities and GPs. The SHAs are the biggest waste of time and GPs are self-employed business people who will not do anything unless they get paid extra. One of the reasons acute beds are beng cut is to make primary and community care take better care of people at home. People with heart failure in the last year of life are admitted on average five times - that's not good for anyone.

"For once I agree with Atlantis"

Steady on Riven !!

"you should target the Strategic Health Authorities and GPs."

Don't get me started on gp's. My gp on wrongly filling out a DLA form for my DD ' I only get paid 17.40 for this after tax, it's really not worth my time'.. grrrr.

But, with hospitals, where has all the money gone? When pensioners are virtually starved to death on wards because there aren't enough nurses and isn't enough time to feed them I have to question priorities.

When people are left in pee soaked sheets because no one had the time or bothered to bring a bed pan/ change the sheets I have to question priorities.

It's all well and good having these 'targets' but when the level of care people are getting falls below even basic care what's the point?

Again I point to my son- a trapped nerve- he wants drugs- pulled muscle- 'man pain'- (dragging one leg behind him)- he's faking- (making pain noises like he's giving birth)- there's nothing wrong- this went on for almost a year until we paid privately (good old credit card) for an MRI which showed a tumour wrapped around his spinal cord. NHS said, we'll see him within a month- two days later full lower body paralysis- we'll find him a bed, it'll be a couple of weeks 'unless I wanted to go privately then today'. Surgeon said 'if we had gotten to him before the paralysis he wouldn't need to learn to walk again'.

This is not an isolated incident, everyone has a horror story, this is not care, it's a bandaid for a amputation, so I ask again, where has all the money gone?

Thats a god question. and I'm not sure I know the answer.

But wat I do know is that in the 8years I've worked in the community the PCT have changed names 3 times with al the resultant sign changes and statonary, management restructure etc.

Teams have been introduced and disbanded.
The Wheel has been reinvented several times over. every time a "new" initiative is introduced someone with 20 or 30 years experience pipes up "oh we used to do it that way 10years ago"

Then there are new departments set up (not frontline) who create policies that clash with other policies. and the paperwork is phenomenal as a result.

People in the acute sector complain that posts are left unfilled but then numbers are low so bank staff have to be employed at more expense . But the accountants who are responsible for releasing funding keep saying that the money isn't there for permanent staff.

In fact Gerry Marsdens programme on fixng the NHS was very accurate.

The public dont necessarily get to hear about the way the nhs is managed. Not all managers are bad. There are many who work very long hours trying t improve things but the culture of the NHS and the way it is managed by Whitehall is damaging.

People frequently say the NHS should be managed by the frontline staff. I disagree.
We're trained as clinicians not managers. But managers should be listening to frontline staff and implementing change that way instead of employing outside agencies at great cost

the government needs to stop interfering so much. Most of it is shortsighted and for political gain. A long term plan and giving a deadline for it to be implemented would be much better instead of constant change.

I saw the report (main headline in Daily Telegraph on Saturday) but would have been more worried if health trusts etc didn't have contingency plans for any eventuality.

The number of managers in the NHS has risen at double the rate of doctors and nurses under Labour, official figures have disclosed.

Some NHS Hospital Chief Exec salaries have risen above £250K - can't find a link for this but it's in today's Torygraph

We are constantly advised by seniour staff to reduce waste (cost) by using certain products, medications which are approved by the hospital, (they say the product is good but we know "good" means "cheaper").

We get the cry "conserve linen" when we have bedding and night wear shortages which means running ward to ward attempting to borrow what we need while they try to keep some in "stock" for themselves. This results in patients with a "minor" mark on their sheet being left unchanged (juice etc). Under no circumstances have I seen a patient knowingly left in soiled sheets. We would personally walk the whole hospital to get a sheet or even and blanket and change the bed.

It feels like there is an audit, (or 5) every other day with results going to target groups to report back to gvt.

They issue new documentation every couple of weeks saying it will only take a few minuts to complete. They don't realise that "a few minutes" for 6/8/12 patients is another small chunk of time AWAY from your patient.

I understand the importance of paperwork but am starting to feel like I am drowning in it. I have to complete a form saying a patient has a needle in their arm, then return 4 hourly and assess the patients arm/ flush the needle and document it all. I will do that while writing in my daily notes, doctors rounds, risk assessments, care plans, observation charts, fluid balance/nutrition charts, relative communication charts. At some point I may "visit" my patients to see they are ok or carry out a "bit of care".

Paperwork is NOT why I became a nurse