Having said that bankers should not advise the NHS this morning, I did a quick consultation with a retired NHS employee who was previously a member of both the Royal College of Phsicians and the Royal College of GPs, and asked her for five recommendations on almost immediate reforms that could be undertaken in the NHS to improve the quality of service supply and to improve staff morale, which is absolutely fundamental to the delivery of success in a service organisation. I am, let's be clear, married to her.
This was her list:
- End all car parking charges for NHS staff working in hospitals .
- Provide high-quality food for all NHS staff rather than the rubbish that is now almost always made available.
- Make sure that high-quality food is available all night for NHS staff when it is normal that at present night shift staff have no food available to them.
- Make sure that the IT works, and that most especially there are printers available at every workstation that can deliver all the various kinds of labels that are still required as a matter of routine in the NHS.
- Senior management should stop treating staff like shit. It really does not help.
You might ask where the patient features in this list, apart from having access to decent food, which seems to be fundamental to proper healthcare, and the answer is that they don't in the first instance. However, unless you have a staff who are treated well you can never treat patients well, and if there are five things to choose, then making sure that staff are in the best possible frame of mine to provide the services that patients need really is important. At the moment the NHS is a long way from doing that.
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Might I add to that that the NHS sets staff retention targets?
The reason being that it will show up where managers are not treating their staff properly and allow appropriate action to be taken.
I would suggest that another easy to implement move might be to recruit more administrative staff where these can be used to release ‘clinical’ staff for clinical duties. Perhaps we need Radar’s in just the same way we need Hotlips and Hawkeyes.*
Radar was the Company Clerk in the TV Series MASH – (Mobile Army Surgical Hospital) who made the whole thing run come what may, Hotlips was the head nurse and Hawkeye was one of the surgeons who could keep people alive when really they should not be.
Retention target? I fear Wes Streeting would leap to the conclusion that handcuffs are the solution.
Streeting’s probably got an Eli Lilley drug for that!…..
BREAKING News: Brand new study from Mankester University “Tirzepatide good for nhs Job Retention figures as well as obese jobseekers” FDA/MHRA Approval expected by end of week!
See, told you!
It is almost imoral that the first three are not always the case..
I don’t pay to park at the school I work at. It is in a smart part of town, I’m not aware of any teachers (let alone support staff) living within walking distance of it.
In days gone by, the matron would make sure that the ward ran as it should.
Today, senior managers aim to make sure the ward runs to a budget, at the expense of patients.
Money before people.
The long term plan is to make sure that the NHS does not work, so it can be privatised.
Labour has already received nearly £1-million in “donations” from private healthcare companies.
Thank you.
Jacqueline should be health secretary, not that young man in a hurry, someone fundamentally unsuited to any workplace, let alone leadership.
🙂
Jacqueline who???
Sometimes known as Mrs Murphy
aka Ms. Funding the Future!!!!!
I am honored to know her name!
🙂
Great suggestions, Professor Murphy, sir. Is no. 4 the result of personal experience?
FWIW, the BMA tells us that there are approximately 9,000 fewer GPs working full-time in the NHS today than pre-pandemic. This is in part a result of 5 (treating staff like shit) during the lockdowns – and no amount of incompletely-trained ‘physician associates’ (PAs, also called ‘GP Assistants’) will address this. In fact, patient-safety, GP job security and productivity will all suffer.
All of those are Jacqueline’s experience – and of others. I was also influenced by Roy Lilley.
The shortage of GPs is also budget cuts. There are unemployed GPs now.
Not just GPs, but newly qualified Allied Health Professionals too – done a degree in physio and can’t get a job as there is no budget for taking on new staff. Where I am the hospital is so badly in debt there is extreme reluctance to take on replacement staff. It’s a fight just to get new biros for the department.
Treating staff well is the essence of good management, so much benefit follows from that – something this and many previous governments fail to comprehend. I can’t think of a time when more people were demoralised by the endless criticism and devaluation of their roles.
Treating staff well is the key to success for so many businesses it is shocking that the NHS does not get this.
That and proper funding. Just remember folks, you too could have kind of healthcare only private insurance life United healthcare could supply.
Every business should understand that expensive private healthcare means wage pressure and diminished disposable income. And very large companies they have a thing called loss leader. This is the device that they sell to you like a phone or gaming console at cost with the idea that the services you spend on the games you buy whatever is where the profits are. For the larger economy, healthcare is kind of like a loss leader. It means that everyone has more money in their pockets to spend on goods and services, and businesses have lower costs. It’s kinda like walkable cities where people don’t have to fork out how many thousands whatever denomination do you want to talk about plus the city spending huge sums to maintain boards and empty storage space that goes idle and is otherwise unproductive in its domain
Curiously, I can find no evidence of outpourings of grief in the U.S. for the untimely departure of the UnitedHealth CEO. Instead, there are thousands of furious posts about the scandalous costs and failures of the health insurance business. UnitedHealth, for example, uses an AI algorithm which essentially denies 32% of claims.
One example:
“ “Our apologies, but bullet wounds are only covered under our platinum+ package,”
That is mild compared to the rest.
Nothing exonerates a murder. But the anger is comprehensible.
Agree 100%, a lesson we had drummed into us when i worked in retail was
“Take CARE of the people, who take CARE of the customers, to take CARE of the business.”
( Substitute customers/ business with patient /service and it works). So if Rachel Reeves and Wes Streeting want lessons from the private sector they should start here as you have correctly pointed out. In fairness the pay awards was a good start.
Agreed.
Ministers just don’t seem to get that.
ERRATUM – 9% fewer FTE GPs, not 9,000. My mistake.
The list addresses an important point – it should be easy and pleasant to work for the NHS, not just ‘rewarding’.
The list makes a couple of assumptions:
1) NHS staff all work in hospitals
2) that NHS staff are able to afford to run a car to commute, and want to use a car
I’d modify it to say “ensure that there is appropriate public transport for all staff, and staff may choose free parking, or free local public transport, or a free quality bicycle as their chosen method of commute”
Food? Yes, but it was ever thus – I clearly remember the cheap, tasty, plentiful slop that staff canteens dished up until private contrsctors came in – who then provided expensive, attractive, meagre offerings. I’d suggest that all hospital catering should be brought back in-house.
I deliberately noted my wife had worked both in hospitals, as a paediatrician, and as a GP. The problems are worse in hospitals, overall. But, your point is a good one everywhere.
Agreed.
In case anyone isn’t aware, there are no hospital car parking charges in Scotland. That includes staff, patients, and visitors alike.
Thanks
I was not aware of that
Since 2008, there has been free car parking at non-PFI (Private Finance Initiative) hospital car parks in Scotland.
Three hospitals still charged for parking after 2008: Ninewells, Dundee, Glasgow Royal Infirmary and the Royal Infirmary of Edinburgh as car parking was provided as part of the horrendously expensive PFI contracts on 30-year leases.
When Covid struck o 2020, parking charges at the remaining 3 PFI hospitals was suspended and eventually in 2021, the Scottish Government struck deals amounting to £35m to buy out the car parks at the 2 PFI hospitals in Dundee and Glasgow.
I haven’t been able to establish if the Scottish Government has completed negotiations to buy out the company which owns the car parks at the Royal Infirmary of Edinburgh, however, there are no charges for parking there.
There are now no charges for parking at any hospital in Scotland for staff or visitors.
That’s really interesting
And shows how expensive PFI is
It is a tax on people
I was asked last week to hang on to my sheet of labels and bring it every time attend.
Labels are scarce.
I would also like to see a return to staff only canteens/ dining rooms, so the staff can eat their (well-cooked, nourishing) food in peace and without queuing for half their break.
True
Scottish government did away with parking charges years ago.
Thanks
Improve staff retention with improved conditions.
Prevent trust managers’ promising promotion positions, e.g. consultant jobs that perhaps are not budgeted.
Increase GP hiring e.g. locum positions are becoming scarce in some regions.
Many years ago, I wrote on my blog about the need for Sleep Pods in hospitals so that on-call and tired staff could catch a power nap in order to be more alert on duty. These Pods would also provide a quiet space for Doctors to relax while dictating their notes after surgery. I was pleasantly surprised to see that Sleep Pods were being trialed in a number of NHS hospitals. Along with access to proper nutrition this is another essential to optimise the productive capacity of staff. Here is the Guardian article that highlights NHS adoption of Sleep Pods:
https://www.theguardian.com/society/2020/feb/03/nhs-hospitals-bring-in-sleep-pods-to-help-tired-staff-take-a-break
Excellent idea, says me, who usually takes a 20 minute nap every day and massively increased my productivity by doing so.
How about the NHS offering a job to every suitably qualified Doctor/Nurse/Whatever currently in the UK?
… to hear the views of someone (your wife in this case) with real experience of the NHS offering sensible solutions to some of the problems that the organisation faces. We need to get people from within the NHS who really understand the issues in the same room as our policy makers and civil service. They are the ones who should be driving the policy changes because they are the ones who most likely know the solutions that work. The idea of recruiting loads more bright boffins to the civil service to dream up clever new ideas (based on agile software development) is exactly the wrong approach.
Streeting seems to be of the ‘beatings will continue until moral improves’ school of management.
Roy Lilley in his blog is worth following. Understand people and has not time for Streeting
I agree with the comments. When my local Wythenshawe Hospital has the food for patients cooked in Flint and delivered in vans. Under PFI rules durin g rhe Blair government new hospitals were built without their own laundries or canteens, these services being outsourced.
A maternity nurse I know was working the night shift the weekend the clocks went back in October. I was shocked when they said that their standard 12 hour shift was actually 13 hours that night because of the clocks going back and they didn’t get paid for that extra hour.
Just paying staff for the hours they do would be a good start.
Agreed
One thing that strikes me in this (and many other post here) is how much care is mentioned.
I’ve just finished David Graebers bullshit jobs and that point about care is raised there too.
I wonder why it isn’t a more central tenet to our politics & economics. Care for fellow humans (as we all are) should be a guiding principle for how we as a species conduct our time on this earth.
It strikes me there are many that do care, but feel trapped by a system indifferent to the suffering it is causing.
And yet, how do we end up with people running both companies and countries that clearly don’t care.
It’s enough to drive you to despair
After a 9 year FREEZE in NHS training bursaries, the bankers seem to have advised an uplift of, wait for it. 2 per cent.
https://www.theyworkforyou.com/wrans/?id=2024-12-06.18413.h&s=speaker%3A25390#g18413.r0
That should solve the recruiting crisis then… a 2% increase to catch up with 9 years inflation in medical student costs.
(I think inflation over 9 years has been about 35% acc to BoE inflation calculator.
Altogether now, “WE CAN’T AFFORD IT!”
Over the same period, MPs basic pay (before allowances & expenses) went up from £74k (May 2015) to £91k (Apr 2024), a rise of 23%.
Amazing….