NHS Admin Role - Overwhelmed

[Riddlediddle]

Not really sure why I'm writing this post -probably just to vent and try and get all of my thoughts out before bed so I can hopefully get some sleep. I'm NHS Admin and I'm just completely overwhelmed by the workload. We are literally drowning in work and everyday the backlog is getting worse and worse. Currently we are only 2 Admin staff supporting a team of 28 Clinicians and a client base of over 6000 patients. Wait times are now so long that all day we are dealing with highly abusive phonecalls from (understandably) upset and frustrated patients demanding to be seen. The inbox to our service is receiving over 300 emails per day so there are currently over 1500 unread emails that I have no hope of getting through and by the end of tomorrow that unread number will have gone up even more. I still have dictation from October to sort, five massive piles of letters as high as me to be written to GPs and other healthcare parties that date back to June, I could go on and on about the backlog of work but basically everyday at work is like hell. I'm constantly stressed and anxious and could just cry with the stress I'm under. I have no time for any kind of personal development as I haven't even got time to do the basic job requirements. We constantly tell management who sympathise and say we should have at least 4 more full time admin for a service with our demand but unfortunately we don't have funding for that and never will. I want to leave (and need to leave for my own sanity) but as this is my first NHS admin role I don't want to jump out of the frying pan into the fire - is this just typical of all NHS admin roles? Is leaving the NHS altogether the only way out of this hell? I've since found out the 2 women who worked in this team before us both had long periods of time off with severe stress and anxiety and both ended up leaving so this has been going on for years and there are absolutely no signs of hope that this will ever change for the better.

I have no doubt that it is quicker to dictate than type, but there is clearly a backlog and the solution at the moment is outdated. Perhaps voice recognition software would be an option, with minor edits being needed instead of full typing.

But I come from a corporate world where in addition to being quite senior I do all of my own typing/correspondence (which is voluminous and sometimes needs to be done in the evening).

You have my sympathy OP. My first job was NHS admin and it was busy, but not that busy. I was single at the time with not much to do at the weekends so it was agreed I could work every weekend on ‘bank’ to get through the backlog (hours and hours of dictation), which suited me at the time. I left after 6 months though (it was a temp role and I declined to stay on permanently). I then got a job in a law firm (which I much preferred) and I have stuck with law firms ever since. Law firms are also busy but it doesn’t feel as ‘life or death’ and therefore doesn’t send my anxiety into overdrive.

It's not going to improve, start looking for another job.

Oh my that sounds ridiculous
Your admin manager should be raising this situation as unsafe
Your clinical team should be raising this as unsafe -
There clinical work must be impacted by the shockingly poor admin provision -
Look for other admin jobs in NHS - they are NOT all this bad, our admin tell they are BORED as it’s so quiet - frequently!!
Don’t go faster, have ALL your breaks -
Only do what you can reasonably manage
Look for other work and let them know that you intend to leave due to the untenable situation you find themselves - management must resolve this !

It sounds dreadful, I recently turned this role down for the reasons you outlined. The interviewer was obviously under so much pressure he got my name wrong and rolled his eyes at me , I walked out of the interview and they still offered me the job ! I don't know what the answer is but it's not an attractive place to work right now.

There are never going to be enough hours in the day and you are not paid enough to go through this stress.

It's not going to change. Your managers do not care who does the job or what gets done, as long as they are being paid, and there is a warm body sitting at your desk.
Take control and get out of there. Your health and sanity is too important to waste.

On the dictation point, I think you're right about the majority of younger clinicians, but in my family there's a senior consultant in his sixties who simply cannot do better than one finger, slow typing. He gave voice recognition software a 6 month trial, but having to proof read his reports as well as interpret the images he was looking at led to more mistakes in both. For some, it simply isn't a viable option, is it really worth reducing the productivity and accuracy of an expert, experienced doctor to save resource on typing?

Look for something else within the trust.

In the meantime, the only way you will survive is to repeat to yourself over and over again, ‘I can only do what I can do’. Take your full lunch break. Start and finish on time without working extra.
The backlog is going to increase, but they need to see that for anything to happen. If you and your colleague run yourselves into the ground to the detriment of your health there’ll still be too much work, and you’ll be covering up some of the issue.
Do what you can do, and it’s horrible dealing with agitated people but the backlog is not your responsibility as you’re being placed in an impossible situation. There are managers who’s job it is to worry about the bigger picture.
Also join the union if you’re not already in it and speak to your shop steward.

I’d go full on whistleblower on this! Surely there are patients whose care is being compromised as a result of this shambles?

It isn't typical of all NHS admin roles. DSis works in a specialist department within a large hospital where, as a result of redundancies, the admin staff has been cut down to less than half. However, there was no real objection because the staff who ended up being made redundant, after a fair selection process, were people who were constantly taking time off on any excuse and who did little or no work on the rare occasions they turned up. DSis is very busy, but not to anything like the extent you are.

When people phone and complain, do you explain that the issue is lack of staff and give them the contact details of whoever is in charge? It's the only way anything will change.

I'm in a similar position in an NHS admin job. Our small team all agreed in November we can only do what we can do. We work our hours (no unpaid overtime), we take our breaks, we do what we can in the time we have. The only way to fix the problem is for people to see the problem as it truly is. We will not work ourselves into the ground and make ourselves ill to cover up the failings of the higher ups who have fucked the budget and not allowed us enough staff to safely do our jobs. Yes things get missed, yes complaints get made, yes people are angry and frustrated and we would love nothing more than to make it perfect for everyone, but that is not something we can do right now, we can only do our best with what we have.

DSis is heavily against doctors typing their own letters. It would make her job easier, but her experience is that they are just not good at writing clearly. If what a doctor writes can't be clearly understood, it carries obvious dangers. If what a doctor has dictated is ambiguous, she tells him/her so and they sort it out between them.

The pain needs to be felt by management, whoever that may be. Instigate a work to rule (keep to your lunch hour and contractual start and finish times) and escalate every complaint to the most senior manager. Also suggest you email them every week or few days detailing what the backlog looks like, what is not getting done, and what decisions you have made to prioritize. Just say "x will not be done as we do not have sufficient staff." This isn't a problem you've created. and it's not in your power to fix it

@Foolsrule

I’d go full on whistleblower on this! Surely there are patients whose care is being compromised as a result of this shambles?

This, I’d whistleblow to the exec board and if that doesn’t work then anonymously to the local paper.

I’d stop answering the phone and also stop listening to voice mails, 99% of this will be patients understandably complaining but it prevents you doing your job. Split your day up and allocate so many hours for dictation, so many hours for GP letters, so many hours for emails. Just work through it all methodically.

Yes, the workload is just going to stack up and stack up but that’s not your fault. Keep raising it, save emails for evidence that you’ve raised it. At some point surely it will blow up and something will have to be done?

I'd look for something else, not all NHS admin jobs are like this. My husband is a consultant and he's fought the corner of his secretary on many points.

The worst being her being expected to move into a massive shared office which about 30 staff when she's clinically vulnerable herself. He moved her desk into his office and now they share it. She's in her 60's and has underlying conditions!

I know that doesn't help you in this job, it's just to say that there are decent working environments out there with staff who look out for each other.

I have no relevant NHS experience, but have worked in high pressure / high workload roles.

Take a deep breath, you can only do what you can do. Take your breaks and your lunch, go for a pee when you need one, you won’t be productive if you are on the edge of burnout.

If it’s easy try and calculate how long the backlogs are e.g. working on dictation from x date, GP letters from Y date. So that you know where you are up to and you can tell people factually. If possible write it on a whiteboard d or something where everyone can see.

Send the service manager and your manager an email setting out the facts and saying the backlog is becoming insurmountable and causing safely risks as urgent items are at risk of being missed. Put your concerns in writing as they are harder to ignore.

If there’s a friendly clinician could they raise it as a safety issue?

If PALS contact you give then the data, “ due to understaffing, as of Monday we are working on letters from x emails from y dates” and hope that they will escalate too.

Leave asap for another NHS admin role, you'll also end up sick if you stay.

Leave. I work in NHS admin and my work load is high but nothing like that, I can keep on top of it. I'm regularly being borrowed by other teams at the moment who are struggling more than us due to lack of staff. This is a management issue. In my trust that kind of mess would have been identified as a massive problem and you would have been given bank staff/overtime etc to clear it. That typing should have been outsourced by now, why are the consultants not escalating concerns about it?! That said I think clinical staff asking for help with silly things may be universal, but it's OK to say no. The problem is that you have unsupportive management and that's not the case everywhere.

Also OP consider speaking to your union rep in the short term and reading your whistleblowing policy.

This is crazy. I am an NHS consultant. I would write a letter voicing your concern to the divisional director. If this does not work you would be justified in leaving the post for your own sanity.

It’s not going to get better so start looking for a different role.
You definitely need to take every break and leave on time.
Not everything will get done and the backlog will get bigger - so let that go. It’s not in your control. Don’t stress about it.

Personally I would:
Stop answering the phone
Decide what I can realistically achieve in a day - write 5 letters, read 10 emails, listen to 10 voicemails or whatever it is - and do that
Email your managers every day/week and update on the back log and what is outstanding, state it didn’t get done due to lack of admin staff hours, and describe the impact on the service eg it is unsafe

Poor management, lack of funding, unsafe service is NOT your problem, not your responsibility, not your stress to take on. Let the highly paid service managers have that stress!

Can you DATIX it? Repeatedly. It might be the quickest way to get something done.

You may need to leave but first take it to a higher level. Email the chief exec and the exec board with what's in your OP here. Email the service lead and say you are not able to meet the service level agreements any longer because you are so under staffed and remind them how often you've raised this before - then stop answering, returning voice mail and so on. As pp said it'll have to get worse for them to act.

The other option is for you and the other admin person to go off sick. At that point money would have to be found for temp cover at least but it would open up how impossible the job is too.

I would leave the phones turned off, first of all. You can’t provide the level of service the senior person has promised with 2 people. Then I would assess how many weeks backlog there is and start working from oldest to newest in each category. Tell management how many weeks backlog there is in each task. I’d also put an out of office/voicemail on so patients are aware of the backlog, how many weeks backlog there is and include there the PALS details and the senior persons details for any complaints/concerns. With the email if you can at least read and tag as urgent, non-urgent or something then you could work through the urgent backlog at a faster rate. Take breaks. I’m sure it will be difficult to do because you take pride in your work, but that’s the only way you can manage the backlog without more resources.

It sounds like what we'd call a "revolving door" job where the conditions are crap and you're treated like dirt by management. For whatever reason it just gets accepted that no one's going to stay in the job for long so nothing is going to change because there is no incentive.

You need to get out, you can't make this better and it will make you ill