The BBC reports Health Minister Wes Streeting has stated that there are, “…too many layers of management, too many layers of bureaucracy… People want to see the front line prioritised, and that is exactly what we’re doing.” As a result, some 18,000 administration and managerial posts are to be cut across the NHS in England this year. This action comes with a hefty price tag to the healthcare system. It requires making significant redundancy payments to the people who are losing their jobs. The belief is that incurring this high cost in the short term will result in considerable savings over the coming years.
Whether you think this is a good idea or not, there are some things that everyone can agree upon. No-one wants to waste precious time or effort in battling through pointless red-tape, completing ambiguous and overcomplicated documents or responding to demands for information which is never acted upon. It’s frustrating to work in systems designed by people who lack insight. In addition, considering the financial challenges, we should definitely not be paying salaries to people who don’t make a worthwhile contribution.
Different opinions
But not everyone is in agreement that dismissing these thousands of NHS workers is the correct course of action. For example, in the same BBC report, the Royal College of Nursing shares their concerns. “Expert registered nurses working across NHS England and ICBs don’t just run vital public health programmes and oversee care programmes for the vulnerable – they connect the NHS and social care services with one another… To imply these are administrators shows a complete lack of understanding of their roles and how they contribute to patient care.”
So what do you think of managers? How will this change impact you in your everyday practice?
During our tutor-led courses, we frequently hear some doctors identifying “management” as being a problem. They may even cite management as being THE problem with the NHS.
What do we mean by “management”?
Let’s pause and differentiate between management as a job title or job role versus management as a behaviour. Management as a behaviour is when we are getting things done through organising people, projects and resources. There are numerous skills which fall under this umbrella, including time-management, root-cause analysis, planning techniques and decision making.
We all manage things on a daily basis in numerous aspects of our lives. We all manage our personal time. For example, we ensure we get to where we need to be to meet friends, to do things with our families or organise days out. We make sure we get things done around the home, keeping it clean, tidy and well stocked with food. From time to time, we undertake a change projects to redecorate or rearrange the furniture.
Now it’s fair to say that some of us are better at this than others!
What about management behaviours in the workplace? Medical leadership is broadly perceived as a noble pursuit. But what about medical management? Medical management is often interpreted through the narrow focus on processes related to patient treatment plans. That’s essential, but there’s much more to consider. What about a doctors ability to make good decisions, manage their own time and delegate effectively? What about managing the processes for making sure things (or people) are getting to the right place in the right quantities at the right time? And what about quality improvement? These practical management skills are essential.
Addressing poor management
Going back to Wes Streeting’s action, the 18,000 employees who are being removed will leave some significant functional gaps which will need to be filled. Some of these gaps will be filled by the administrators and managers who remain. Others will fall to the healthcare professionals who work in the front line. That includes doctors who are already juggling numerous challenges. The demands for being well organised, able to prioritise and get things done only ever seem to increase.
There’s general consensus that poor management practices exacerbate the challenges which face the NHS and these problems must be addressed. But that has to be true whether it’s poor management by some faceless worker in a distant office or by a doctor who is part of a busy team.
In sharp contrast, good management behaviors across all levels and all roles is an essential element for achieving improvement.
What steps are you taking to improve your management capabilities?
Stephen McGuire – Managing Director
