| The new Andrew Lansley? 13:23 - Jan 23 with 1387 views | DJR |
He was supposed to be giving a speech about this this morning but rather ironically, given his health portfolio, he was ill and Karin Smyth delivered it instead. Perhaps he didn't fancy the follow up questions.
As it is, the average real term increase in NHS spending under the Tories since 2010 has been far below that of any government since the war, and this at a time of a rapidly growing and ageing population. And between 2022/23 and 2024/25, spending on health and social care is projected to increase by an average of 0.1 per cent a year in real terms, so things are certain to go downhill from an already desperate position with both parties signed up to identical fiscal policies.
[Post edited 23 Jan 2024 13:35]
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| The new Andrew Lansley? on 13:51 - Jan 23 with 1279 views | Help |
Options are investment and reform, which sounds rather tory. Or for those that can and don't already have it, consider private health care. It is the way the Tories want us to go. Because at the moment the NHS is flat on its back. It is not the NHS it was originally intended to be for various reasons. It will not be the NHS some want it to be. So it has to become something for some and it wont be available for others |  |
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| The new Andrew Lansley? on 17:03 - Jan 23 with 1171 views | BlueBadger |
Reform AND funding are needed.
Even in a huge organisation, there's an excess of managers who aren't actually managing or contributing anything useful(particularly in areas related to management of private sector contracts) and the whole system of private contractors taking on state work is riddled with incompetence, corruption and waste - we don't know exactly how much it costs us, but it isn't cheap and mainly exists to add bureaucracy, barriers to joined-up care and the odd bit of corruption.
But, the cost of treatments is ever increasing, the population is aging and we are bleeding staff(particularly experienced 'shop floor' level staff) at a terrifying rate due to ever worsening pay and conditions. That can't just be solved with 'reform', that ultimately, costs money.
Additionally, it's pointless reforming and funding the NHS if nothing is done to support the home and community care sectors which are often council or even charity run. [Post edited 23 Jan 2024 17:06]
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| The new Andrew Lansley? on 17:24 - Jan 23 with 1123 views | lowhouseblue |
i read recently that the rise in total nhs employment (expressed as FTEs) under the tories since 2010 had been 34%. can that really be true? |  |
| And so as the loose-bowelled pigeon of time swoops low over the unsuspecting tourist of destiny, and the flatulent skunk of fate wanders into the air-conditioning system of eternity, I notice it's the end of the show |
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| The new Andrew Lansley? on 17:45 - Jan 23 with 1066 views | BlueBadger |
| The new Andrew Lansley? on 17:24 - Jan 23 by lowhouseblue |
i read recently that the rise in total nhs employment (expressed as FTEs) under the tories since 2010 had been 34%. can that really be true? |
I can only speak anecdotally but in the past ten years the number of bodies looking after patient flow at [redacted] General haas mushroomed.
Back in the day, you had a bed manager(who may or may not have been a registered nurse) who deferred the occasional difficult question to the duty manager.
Now we have:
Bed coordinator(unqualified, manages ins and out)
The duty manager(who takes a much more hand-on role in patient flow)
The clinical flow coordinator(may be one on duty, may be two) - I have no idea what they do. Having chatted to them, I'm not sure THEY know what it is they add
The Tactical manager(the person who has overall responsibility). Their role appears to be to say 'no' when the duty manager suggests we divert stroke calls elsewhere because we have no physical capacity for strokes.
The manager of the discharge waiting area and virtual ward also have some input to add.
Does patient flow work better as a result? Does it fookery. Granted, external factors are mainly at play as why it's effectively ground to a halt but getting a simple placement decision for someone who requires a specialist area beds 'in hours'(in particular) can often involve going through multiple people.
And then there's the matrons. Every ward at [redacted] now has a matron((Again, I have no idea what the matrons actually DO beyond attend meetings - (which are sometimes about previous meetings) as well as a nurse manager and service manager(one looks after the clinical side of things, the other handles the money.
Previously these individuals would look after a particular specialist area(ie, theatres, ED) or cluster of wards(for example, the general surgical wards), now there's one each.
And then there are SENIOR matrons. I have even less idea about what THEY do.
then we have 'tactical' level management - who are about Trust strategy during the day/week/period of industrial action/major incident/etc. Their job appears to mainly involve Zoom meetings and clipboards.
Getting actual hard numbers on these is difficult but my experiences suggest 'yes', to me. | |
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| The new Andrew Lansley? on 18:15 - Jan 23 with 1021 views | DJR |
| The new Andrew Lansley? on 17:03 - Jan 23 by BlueBadger |
Reform AND funding are needed.
Even in a huge organisation, there's an excess of managers who aren't actually managing or contributing anything useful(particularly in areas related to management of private sector contracts) and the whole system of private contractors taking on state work is riddled with incompetence, corruption and waste - we don't know exactly how much it costs us, but it isn't cheap and mainly exists to add bureaucracy, barriers to joined-up care and the odd bit of corruption.
But, the cost of treatments is ever increasing, the population is aging and we are bleeding staff(particularly experienced 'shop floor' level staff) at a terrifying rate due to ever worsening pay and conditions. That can't just be solved with 'reform', that ultimately, costs money.
Additionally, it's pointless reforming and funding the NHS if nothing is done to support the home and community care sectors which are often council or even charity run. [Post edited 23 Jan 2024 17:06]
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What you say is right but I don't think Labour will be doing anything about contracting out. | | | |
| The new Andrew Lansley? on 18:21 - Jan 23 with 1001 views | DJR |
| The new Andrew Lansley? on 17:45 - Jan 23 by BlueBadger |
I can only speak anecdotally but in the past ten years the number of bodies looking after patient flow at [redacted] General haas mushroomed.
Back in the day, you had a bed manager(who may or may not have been a registered nurse) who deferred the occasional difficult question to the duty manager.
Now we have:
Bed coordinator(unqualified, manages ins and out)
The duty manager(who takes a much more hand-on role in patient flow)
The clinical flow coordinator(may be one on duty, may be two) - I have no idea what they do. Having chatted to them, I'm not sure THEY know what it is they add
The Tactical manager(the person who has overall responsibility). Their role appears to be to say 'no' when the duty manager suggests we divert stroke calls elsewhere because we have no physical capacity for strokes.
The manager of the discharge waiting area and virtual ward also have some input to add.
Does patient flow work better as a result? Does it fookery. Granted, external factors are mainly at play as why it's effectively ground to a halt but getting a simple placement decision for someone who requires a specialist area beds 'in hours'(in particular) can often involve going through multiple people.
And then there's the matrons. Every ward at [redacted] now has a matron((Again, I have no idea what the matrons actually DO beyond attend meetings - (which are sometimes about previous meetings) as well as a nurse manager and service manager(one looks after the clinical side of things, the other handles the money.
Previously these individuals would look after a particular specialist area(ie, theatres, ED) or cluster of wards(for example, the general surgical wards), now there's one each.
And then there are SENIOR matrons. I have even less idea about what THEY do.
then we have 'tactical' level management - who are about Trust strategy during the day/week/period of industrial action/major incident/etc. Their job appears to mainly involve Zoom meetings and clipboards.
Getting actual hard numbers on these is difficult but my experiences suggest 'yes', to me. |
I came across this from a recent Nuffield Trust report.
"While it appears the UK as a whole have relatively few staff in key groups compared to other developed countries, different countries have different levels of skill-mix, with the UK (particularly in England) employing more support staff per head compared with other nations."
But I am not convinced Labour will do much about this, given they seem as keen on marketisation as the Tories, which brings with it bureaucracy. [Post edited 23 Jan 2024 18:23]
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| The new Andrew Lansley? on 21:03 - Jan 23 with 885 views | jontysnut |
| The new Andrew Lansley? on 17:03 - Jan 23 by BlueBadger |
Reform AND funding are needed.
Even in a huge organisation, there's an excess of managers who aren't actually managing or contributing anything useful(particularly in areas related to management of private sector contracts) and the whole system of private contractors taking on state work is riddled with incompetence, corruption and waste - we don't know exactly how much it costs us, but it isn't cheap and mainly exists to add bureaucracy, barriers to joined-up care and the odd bit of corruption.
But, the cost of treatments is ever increasing, the population is aging and we are bleeding staff(particularly experienced 'shop floor' level staff) at a terrifying rate due to ever worsening pay and conditions. That can't just be solved with 'reform', that ultimately, costs money.
Additionally, it's pointless reforming and funding the NHS if nothing is done to support the home and community care sectors which are often council or even charity run. [Post edited 23 Jan 2024 17:06]
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Some in the NHS might say that the last thing anyone needs is more reform - just let us get on with the job. There's the toilet roll paradox. At some point someone will say the NHS pay £5 per toilet roll. Purchasing must be centralised. A few years on, someone will say toilet rolls still cost £5, purchasing must be devolved. And so it goes. |  | | |
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| The new Andrew Lansley? on 21:30 - Jan 23 with 829 views | BanksterDebtSlave |
| The new Andrew Lansley? on 17:45 - Jan 23 by BlueBadger |
I can only speak anecdotally but in the past ten years the number of bodies looking after patient flow at [redacted] General haas mushroomed.
Back in the day, you had a bed manager(who may or may not have been a registered nurse) who deferred the occasional difficult question to the duty manager.
Now we have:
Bed coordinator(unqualified, manages ins and out)
The duty manager(who takes a much more hand-on role in patient flow)
The clinical flow coordinator(may be one on duty, may be two) - I have no idea what they do. Having chatted to them, I'm not sure THEY know what it is they add
The Tactical manager(the person who has overall responsibility). Their role appears to be to say 'no' when the duty manager suggests we divert stroke calls elsewhere because we have no physical capacity for strokes.
The manager of the discharge waiting area and virtual ward also have some input to add.
Does patient flow work better as a result? Does it fookery. Granted, external factors are mainly at play as why it's effectively ground to a halt but getting a simple placement decision for someone who requires a specialist area beds 'in hours'(in particular) can often involve going through multiple people.
And then there's the matrons. Every ward at [redacted] now has a matron((Again, I have no idea what the matrons actually DO beyond attend meetings - (which are sometimes about previous meetings) as well as a nurse manager and service manager(one looks after the clinical side of things, the other handles the money.
Previously these individuals would look after a particular specialist area(ie, theatres, ED) or cluster of wards(for example, the general surgical wards), now there's one each.
And then there are SENIOR matrons. I have even less idea about what THEY do.
then we have 'tactical' level management - who are about Trust strategy during the day/week/period of industrial action/major incident/etc. Their job appears to mainly involve Zoom meetings and clipboards.
Getting actual hard numbers on these is difficult but my experiences suggest 'yes', to me. |
Seems like what you need is a syndicate of workers with direct control of your work environment. Perhaps think of it as a co-operative if syndicalism is too anarchist sounding. |  |
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| The new Andrew Lansley? on 07:54 - Jan 24 with 671 views | Swansea_Blue |
| The new Andrew Lansley? on 17:45 - Jan 23 by BlueBadger |
I can only speak anecdotally but in the past ten years the number of bodies looking after patient flow at [redacted] General haas mushroomed.
Back in the day, you had a bed manager(who may or may not have been a registered nurse) who deferred the occasional difficult question to the duty manager.
Now we have:
Bed coordinator(unqualified, manages ins and out)
The duty manager(who takes a much more hand-on role in patient flow)
The clinical flow coordinator(may be one on duty, may be two) - I have no idea what they do. Having chatted to them, I'm not sure THEY know what it is they add
The Tactical manager(the person who has overall responsibility). Their role appears to be to say 'no' when the duty manager suggests we divert stroke calls elsewhere because we have no physical capacity for strokes.
The manager of the discharge waiting area and virtual ward also have some input to add.
Does patient flow work better as a result? Does it fookery. Granted, external factors are mainly at play as why it's effectively ground to a halt but getting a simple placement decision for someone who requires a specialist area beds 'in hours'(in particular) can often involve going through multiple people.
And then there's the matrons. Every ward at [redacted] now has a matron((Again, I have no idea what the matrons actually DO beyond attend meetings - (which are sometimes about previous meetings) as well as a nurse manager and service manager(one looks after the clinical side of things, the other handles the money.
Previously these individuals would look after a particular specialist area(ie, theatres, ED) or cluster of wards(for example, the general surgical wards), now there's one each.
And then there are SENIOR matrons. I have even less idea about what THEY do.
then we have 'tactical' level management - who are about Trust strategy during the day/week/period of industrial action/major incident/etc. Their job appears to mainly involve Zoom meetings and clipboards.
Getting actual hard numbers on these is difficult but my experiences suggest 'yes', to me. |
It’s the modern day scourge of many large organisations unfortunately. Right up there with using consultants to reform processes when you’ve got better knowledge in house.
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