NHS problems from the horses mouth

I have been saying this, on here and in RL, for years and years.

They do not need managers, whatever politicians might imagine.

Ah, the "horse's mouth."

We're doomed.

So have we been saying it for years, but most of the population want to keep chucking money at it.

Does anyone remember John Harvey Jones going into hospitals and looking how they were being run, now there was a man who spoke sense.

I've also thought this for some time.

A couple of years ago I volunteered at our local hospital and was put to work in some of the offices. These were staffed by managers, loads of them, at all different levels.

I was present at a meeting one day and the amount of managers was incredible.

Get rid of some of the middle managers and pass the salaries on to the people on the front line, doctors and nurses.

So if hospitals don't need managers, who is going to be responsible for recruitment, maintenance, the appointments and record keeping systems, cleaning, catering, ordering equipment, prioritising patients, making sure that budgets aren't overspent (and all the other tasks I've forgotten)?

growstuff

So if hospitals don't need managers, who is going to be responsible for recruitment, maintenance, the appointments and record keeping systems, cleaning, catering, ordering equipment, prioritising patients, making sure that budgets aren't overspent (and all the other tasks I've forgotten)?

The magical "hospital secretary", presumably, Growstuff.

Who can apparently implement things without anybody allocating any funds to them.

My sister was a middle manager in a hospital trust. She came from a nursing background. The problem for her was that there weren't enough managers, especially as the government imposed more initiatives and targets. As an increasing number of managers weren't replaced when they left, her workload was ridiculous.

They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.

Casdon - we need you!!

There were always some managers but the proliferation over the years has resulted in the mess now in place.
That Telegraph letter is not wrong.

LadyGracie

They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.

This, totally.

volver

growstuff

So if hospitals don't need managers, who is going to be responsible for recruitment, maintenance, the appointments and record keeping systems, cleaning, catering, ordering equipment, prioritising patients, making sure that budgets aren't overspent (and all the other tasks I've forgotten)?

The magical "hospital secretary", presumably, Growstuff.

Who can apparently implement things without anybody allocating any funds to them.

Oh! You mean the ones who know so much about running a hospital that they should be in charge?

Management by the staff was tried at Hinchingbroke Hospital, but was a disaster. It was judged to be the second most inefficient hospital in England before the contract was handed back to the NHS

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

Oreo

There were always some managers but the proliferation over the years has resulted in the mess now in place.
That Telegraph letter is not wrong.

Do you have direct experience at a senior level?

kittylester

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

I wonder if they actually know what "management" does.

LadyGracie

They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.

Maybe the government should stop issuing more and more targets.

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

growstuff

kittylester

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

I wonder if they actually know what "management" does.

Not an anecdote about the NHS, but about knowing what managers do...

The manufacturing company I worked in decided to have 2 people from the "factory floor" on the senior management team. In part, because there were lots of complaints that the managers didn't have any idea what was right for the company.

When they finally managed to get a couple of people to take on the responsibility, they lasted two meetings then decided it was too hard.

King's Fund (2012):

"The NHS in England is a £100 billion-a-year-plus business. It sees 1 million patients every 36 hours, spending nearly £2 billion a week. Aside from the banks, the only companies with a larger turnover in the FTSE 100 are the two global oil giants Shell and BP. If the NHS were a country it would be around the thirtieth largest in the world.

If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under- rather than over-managed."

www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

The government actually makes most decisions. The managers just enforce them.

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

Managers are not administrators.

signed, a former manager

(Who generally knew what she was talking about. Not NHS)

growstuff
Just because your sister was a manager in a hospital trust doesn’t mean that you are an expert.
Just as having a sister who was a teacher in a particular school doesn’t make a poster an expert on what happens in all schools.
There have been many articles written by hospital doctors and consultants over the past 25 years bemoaning the rise of the hospital managers.

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

Luckygirl3
A good summing up of the situation.👏🏻👏🏻👏🏻

the letter writer seems to ignore the input of nursing staff in the efficient running of a hospital.