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Deleted member 5849
Guest
Fair.
Also the need to be transparent and give 'value' means you can't pay competitive rates, which means there's a relatively high turnover in some areas, meaning limited experience in certain roles.
Do you want to discuss boring politics? (113 Viewers)
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Also the need to be transparent and give 'value' means you can't pay competitive rates, which means there's a relatively high turnover in some areas, meaning limited experience in certain roles.
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Deleted member 9744
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If you get rid of the managers, all the organisation/admin has to be done by doctors and nurses. Complete waste of their time and expertise. This applies in many areas including the police too.
There's always this call to employ more front line professionals and cut managers/admin staff. Wherever this happens it results in the professionals complaining about all the admin they have to do. Often the problem is that things are not managed effectively, meaning that medical expertise is wasted.
shmmeee
Well-Known Member
Exactly this. “Make neurosurgeons do admin” suddenly doesn’t sound so sensible. Just the politics of envy anyway
Sky Blue Pete
Well-Known Member
He made a criminal error and will hopefully serve time for it for sending infected patients back to care homes at the start of the pandemic.
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Deleted member 9744
Guest
But, but... he said he threw a protected ring around care homes. You mean to say that wasn't true??
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Spot on. It’s been the same for years. Not only do they protect themselves they’re part of the problem. They don’t deliver so consultants are brought in at crazy day rates to do what management should be doing.
I don’t blame Nurses for striking. If anyone deserves an inflationary pay rise it’s them. Hopefully it won’t get to that, government is on a massive losing battle on this one
ps the nhs is broken, there needs to be some big, bold, cross party decisions on it and quickly. It’s not fit for purpose for how we as a country live and use it
Spot on. It’s been the same for years. Not only do they protect themselves they’re part of the problem. They don’t deliver so consultants are brought in at crazy day rates to do what management should be doing.
I don’t blame Nurses for striking. If anyone deserves an inflationary pay rise it’s them. Hopefully it won’t get to that, government is on a massive losing battle on this one
ps the nhs is broken, there needs to be some big, bold, cross party decisions on it and quickly. It’s not fit for purpose for how we as a country live and use it
Sick Boy
Super Moderator
It’s broken because it lacks funding.
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Deleted member 5849
Guest
To a degree yes. It'd be a lot easier to believe change was being looked at for the right reasons if it were coupled with a massive funding boost at the same time, however.
shmmeee
Well-Known Member
Is there an existing model you feel works better?
It’s not just funding, although social care in particular needs significant additional funding as that’s blocking a significant proportion of hospital beds
We have 1.4m people working in the NHS (inc SC), pour in £600bn+ pa and have over 10% of the population with PMI ?? yet you can’t get a GP appt easily and waiting lists aren’t coming down
Basically we have a growing, aging population and an obesity crisis for starters. Our population has grown by 8% (5m) since 2010, something like 65-70% of people are overweight or obese with 1m hospital admissions per annum where obesity was a factor and we have something crazy like a third of beds being taken up by people who don’t need to be in hospital.
One where the country stops taking it for granted for starters and where processes/management are far better. One where we have bursaries and/or encourage nurses at certain levels without having degrees. Numerous things need changing. Just pumping money in, whilst helping, won’t solve the various problems
shmmeee
Well-Known Member
Agree with a lot of that. IIRC the NHS has some of the lowest admin costs in the world only Japan and Italy lower in developed countries.
I’m not averse to a European type system, but having seen my girlfriends family have to use GoFundMe to get care for their autistic son doesn’t fill me with confidence.
I wish people would stop being silly about data TBH, especially the Labour Party. We could be world leading and it could lead to huge efficiencies. We had the world leading machine learning company desperate to work on the NHS for free and we basically blocked them because “data scary”.
As I said earlier in the thread a proper investment in government digital capability could reap massive rewards instead of farming it out to places like Capita or other consultancies.
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Deleted member 9744
Guest
It is mostly funding which means it is constantly just firefighting and doesn't have the capacity to put in place measures to prevent/delay people getting unwell like anti obesity strategies. This isn’t helped by the Tories' view that such strategies are 'nanny state gone mad'.
fernandopartridge
Well-Known Member
No. The conservative government has deliberately and wilfully starved it of the resource it needs. The conservative party needs to be destroyed.
skybluetony176
Well-Known Member
He’s having a mare. People keep trolling him by replying to him with Daily Mail articles that say the exact opposite of what he’s trying to claim MHancock achieved. Short memories some people.
shmmeee
Well-Known Member
I got into it with him about Net Zero the other day. Man’s a moron.
skybluetony176
Well-Known Member
Prison service too. Prisons have tons of inmates that should either be in some sort of social care environment or have been let down by social and healthcare (not their faults, it’s a result of austerity, not the skill and dedication of people involved in it) in dealing with mental health and addiction issues.
David O'Day
Well-Known Member
only decision needed is to properly fund it
Ian1779
Well-Known Member
Merely replicating the example provided by government around frivolous wastage and overpaying beyond capability and contribution.
skybluetony176
Well-Known Member
It’s a good joke but the fact that she blamed him and now he’s blaming her just shows why neither of them should have been allowed anywhere near government ever, let alone PM and chancellor. Aside from the obvious lack of ability they clearly lack the maturity. Pair of children. Just waiting for a joint interview where it’s just them two repeating to each other “I know you are but what am I” for 30 minutes.
Agree, there could be improvements using better processes, data and non front line people doing their jobs properly. I’ve read before that Sunak is big on data supporting decisions etc so maybe he could drive some change even if only for a couple of years.
Also off the top of my head…
I’d be asking the best business minds (likely retired) to volunteer to sit on the boards of all hospital trusts just to bring a different perspective to processes, savings (away from front line) etc.
Better integration of social care and hospital system needs to be one of the priorities and will need money throwing at it, especially at more carers/their salaries. Major hospitals could maybe have some kind of short term overflow building/space nearby where reduced care/oversight is required to free up beds.
I heard of a successful trial scheme of a GP sitting in A&E dealing with many of the patients immediately on arrival. The only way to bring A&E down is to get people who don’t need to be there home asap and help with bed blocking (fix post hospital care/social care and I think fair a bit of pressure would be released from the system).
Resolve doctors issues with punitive pension tax penalties if they retire later to encourage more to stay on, even part time
Get nurses wages/incentives/flexible working right to reduce amount of those moving to agency. I heard from someone at the QE a lot left the NHS after covid, not for pay/pressure but because they were getting no/poor visibility on shifts and basically little appreciation of this from above
Finally, there needs to be some charges/penalties for certain things like missed appointments. Doctors always say cost to administer will outweigh income generated but that’s why doctors don’t run businesses. It’s not about that, we need a cultural shift in this country to stop people taking the piss and if that means some charges, so be it. Very different but look what happened with supermarkets and plastic bags charges.
As I say, it needs some big, bold, innovative decisions and changes, in addition to targeted investment. I’m just not convinced politicians from any party or senior people within NHS will deliver this but we live in hope
ps apologies all for the long ranty ramble. I just get so frustrated that the only solutions are throw more money at the problem without even trying to resolve the issues that will suck up that extra cash immediately
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Sky_Blue_Dreamer
Well-Known Member
I'm not saying that there doesn't need to be admin staff to do all this stuff, just I feel that they're compensated far too highly in comparison to frontline staff.
The thing with having the best business minds is that they're business minds. It's the National Health Service, not the National Health Business. Not everything that you would do in a business would work where the emphasis is on the service prvoided, not the returns gained. As you said "that's why doctor's don't run businesses". It's the same in reverse - that's why business people don;t run doctor's.
For example, business tend to run where everything is just about able to be done with the level of staff required, and sometimes beyond that. As long as the money's still coming in they don't care. I don't want a health service that's run with the absolute minimum number of staff, especially frontline. I know we're currently doing that, because we don't value the staff enough and people want to leave.
I agree about integration with social care. But again that's a growing issue that needs drastic funding to cope with the level of demand it's seeing and will only increase. I agree about charges for missed appointments, though think punitive penalties on pensions would discourage more people from becoming doctors. MAybe we should try and make it so the job is more satisfying so they're happy to work to an older age rather than being given far too many patients to deal with.
shmmeee
Well-Known Member
My GF who works in the NHS is a big fan of charging for missed appointments. I always think of a story in I think Freakonomics or another popular economics book, about a nursery that kept having parents pick up late so decided to charge parents who weren’t on time. The number of parents turning up late increased massively because people didn’t feel guilty if they were paying so made no effort to be on time, just took the fine. So it’s not always as clear cut.
I think we have to accept healthcare is expensive and is a voter priority so money has to be found. My experience of “business people” in the public sector is much like Elon Musk buying Twitter: they tend to have a poor surface level understanding of the issues and often make the same mistakes that experience could avoid. I’m not sure experience selling widgets has much relevance in providing public services TBH.
There’s a fetishisation of business leaders but mostly it’s survivorship bias. The vast majority fail and a few get lucky.
These things cost money, but the money they make back in productivity more than pay for themselves.
fernandopartridge
Well-Known Member
You talk as if the NHS at all levels doesn't spend a fortune on expert advice from business including all of the mighty consultancies.
duffer
Well-Known Member
A couple of assumptions here.
The first is that the NHS is a black hole for funding. Maybe, but compared to most of our equivalent countries we're underfunding it and have been for a long time.
The second is that we've also been looking for "efficiencies" in the NHS for a very long time too, with endless business specialists and consultants brought in at great expense. So it's a myth that it's a hugely inefficient organisation that can be magically fixed.
Like most things in life, you get what you pay for, and if we continue to fund the NHS at the minimum possible level we'll get the minimum possible service. The choice is ultimately ours, but there's no magic bullet.
Taxes and health care funding: how does the UK compare?
How much does the UK raise in taxes and spend on health care in comparison to other countries? We look at the facts.
stupot07
Well-Known Member
Management in the NHS is actually incredibly lean. NHS managers make up 2% of the workforce compared to circa 9.5% of the UK workforce
Is the NHS overmanaged?
An in-depth look at one of the most persistent questions on NHS management.
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stupot07
Well-Known Member
Whilst theres always room for improvement, Its not poor management, its lack of funding, and lack of trained professionals, and a lot of that goes back to lack of funding and adequate pay.
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stupot07
Well-Known Member
My experience of consultancy firms in the public sector is they are extremely expensive and provide minimal benefit. But the government likes them.
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stupot07
Well-Known Member
Health Spending per capita comparison
Medical workforce is about 25 years behind EU. GP numbers are below 2014 worst case scenario forecast:
www.gponline.com
Nurse and medical workforce levels are one of the lowest in the Western world. We also have one of lowest number of hospital beds per capita.
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Medical workforce is about 25 years behind EU. GP numbers are below 2014 worst case scenario forecast:
GPs per patient slump as NHS medical workforce '25 years behind EU', BMA warns
England's medical workforce is 25 years behind comparable EU nations according to a damning BMA report that warns GP numbers are below a worst-case prediction from government advisors in 2014.
www.gponline.com
Nurse and medical workforce levels are one of the lowest in the Western world. We also have one of lowest number of hospital beds per capita.
NHS has one of lowest levels of doctors and nurses in western world
www.nationalhealthexecutive.com
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