Cable Forum - View Single Post - Millions to be affected by NHS plan to ration 34 everyday tests and treatments

**Hugh** · 04-12-2019, 15:15

Quote:

Originally Posted by OLD BOY

You are re-writing history if you are trying to deny now the mess that Labour left behind when they lost power, and you are ascibing views to me and others that we do not have.

As far as the NHS is concerned, I would remind you that the Conservatives stripped a huge layer of management out of the NHS after they came to power in 2010 and nobody seems to have noticed! We have a way to go yet. Problems are not resolved just by throwing money at them and the measure of a well-run service is not how heavily they are sponsored by the State.

---------- Post added at 09:41 ---------- Previous post was at 09:34 ----------

Who said we need to be like the US?

That statement is factually incorrect - the numbers started going down in 2007.

Quote:

This attack on management and their poor handling of the NHS is a familiar refrain, with even the former Minister for Health Jeremy Hunt joining in by declaring: “We should today ask whether the NHS made a historic mistake in the 1980s by deliberately creating a manager class who were not clinicians.”

And successive governments have backed up their doubts about the value of managers. From 2007 to 2012 the average ratio of managers to staff in the NHS fell by nine per cent.

This is despite changes to NHS organisations, such as the shift to Foundation Trusts, which increases autonomy, responsibility and arguably demands more managers, not fewer. However, from the political left and right, both agree that there are too many managers in the NHS.

But our research debunks that myth, finding instead a strong statistical link between an increase in the number of managers and the performance of hospital trusts on a number of measures.

In fact, according to the data, the NHS would be wise to put aside a portion of the annual £20 billion to hire more managers, especially as the Government will apply five tests on plans to use the money, which are:

Improving productivity and efficiency
Eliminating provider deficits
Reducing unwarranted variation in the system so people get consistently high standards of care wherever they live
Getting much better at managing demand effectively
Making better use of capital investment
Meeting these tests will require good management, and that will probably require more managers, something the NHS is severely short of compared to other sectors.

In a highly complex organisation like the NHS - the fifth biggest organisation in the world - managers are needed to co-ordinate tasks to meet these Government tests.

Currently there are around 31,000 managers employed in the English NHS. About a third of those are ‘hybrids’ – doctors or nurses with a frontline position and a management role – while the rest are dedicated managers. But in an organisation of 1.36 million employees that amounts to less than three per cent of the workforce.

This contrasts with the UK economy as a whole, where managers make up 9.5 per cent of the workforce. It might be there are other roles that involve some sort of management, but such a disparity makes it hard to argue the NHS has too many managers.

Indeed, our research shows that more managers will help the NHS meet the Government’s tests, particularly around efficiency. With my colleagues Ali Altanlar and Gianluca Veronesi, we used data from 150 acute hospitals in England from 2007 to 2012 to find out what impact managers have on performance.

This study found that even a small increase in the proportion of managers (from two to three per cent of the workforce in an average hospital trust) could be significant.

Although having only a modest impact on patient satisfaction, larger numbers of managers resulted in a five per cent improvement in hospital efficiency and a 15 per cent reduction in infection rates.

https://www.wbs.ac.uk/news/how-many-...uk-s-nhs-need/

The clue's in the title - managers manage workloads and budgets, allowing the clinicians to focus on patients.

---------- Post added at 15:15 ---------- Previous post was at 15:02 ----------

CF'ers may find this informative (it's from 8 years ago, and the reporting and funding have got even more complex since then).

https://www.kingsfund.org.uk/publica...rs-and-the-nhs

Quote:

For primary care trusts (PCTs), the recent Health Select Committee Report into Commissioning identified a continuing rise in administration costs dating from the purchaser-provider split in 1991 and was critical of the government's inability to supply 'clear and consistent data about transaction costs' relating to billing and commissioning.

The regulatory framework for health care in England has also become more complicated. A report in 2009 by the Provider Advisory Group, made up of NHS and independent sector providers, concluded that there was unnecessary duplication in the information NHS providers in England are required to submit to the 35 key regulators, auditors, inspectorates and accreditation agencies. Supplying this information has led to an increase in the number of non-clinical staff employed by the NHS.