It was announced in the hospital that we had to start loosing staff to save money:
"to then identify particular at risk posts within each area. In order to ensure there is no impact on front line services the pool of staff at risk of redundancy will not include front line clinical posts, such as nurses, doctors and allied health professionals. Individuals at risk will include managers and administrative staff at all levels, particularly from corporate functions, based on the pool comprised of those with less than 24 months continuous NHS service."
[My emphasis]

Two people from Medical Physics were made redundant - fortunately one post was successfully fought and was withdrawn from the list.
They were not "managers and administrative staff" but technical people.

Beware of cuts that are occuring across the country, it seems that even though we think our roles are vital we seem not to be included in the group "front line clinical posts"

Robert

It is important to justify your department, QA is one way to show that you are doing a good job.

It's amazing how i am expected to do training on swine flu, disability, child protection and the like as a member of front line staff, but when it comes to swine flu jabs and the rest i am not considered to be frontline.

I wonder if it has anything to do with meeting targets for numbers of staff who have carried out training.

Lee

@Robert: what about the "Outreach" and "Diversity" Managers?

@Lee: swine 'flu - what happened to the pandemic? Could this have been yet another damp squib (as predicted), or simply a scare-mongering tactic by Nanny?

@Umish: looks like you're missing the point here. Doing a good job (or otherwise) has very little (nothing) to do with it, unfortunately.

To understand the NHS you need to bone up on things like left wing political agendas, social engineering, tribal loyalties (cronyism), jobs for the "chosen ones" ... and "Common Purpose" in general. Sadly, decent public healthcare for the masses comes quite a way farther down the list.

Regrettably, the NHS as it stands is the very epitome of Big Brother Britain. Obscenely large amounts of money are bunged at it but it remains, shall we say, as inefficient as ever. The only sensible way forward would seem to be to dismantle this behemoth and start again.

May I commend and suggest the French model.

What is more galling is that in the same message about cutting staff, a block on recruitment cutting of overtime and agency staff (but not the work load) are welcomes to new managers.

We also have several "frozen" posts but they do not count as lack of staff as they still appear on numbers sheets. The fact that there is no one allowed to be recruited to them so no one is there to do the work does not count.

And we have worse to come a 10% cut in staff over all. With 7000 staff that is 700 people to go. What is worse is that it seems to be people that have to go not frozen posts as that does not save them money..... a double whammy if ever I saw one.
A department full of frozen posts, perhaps that is what happened to the Marie Celeste. The positions were there it was just that the posts were not filled with crew.


Robert

"The only sensible way forward would seem to be to dismantle this behemoth and start again."

Dare,nt you mention the dread word PRIVATISATION then Geoff ??

@Tony: not necessarily. I believe that Britain was at its Best (in Modern Times, that is) when we operated under the so-called "Mixed Economy". That is, stuff that faired best in private hands stayed there, and stuff that needed to be Nationalised, er, was!

@Robert: it's clear to me (as an outsider, looking in) that there is some sort of agenda at play here. Let it all go down the pan, Mate. Sooner or later they'll have to call in armies (well, platoons) of techs to sort out the piles of broken kit.

From the medical equipment perspective, it sounds like the only parties likely to gain from all this will be the manufacturers and suppliers. Because no doubt "funding will be made available" to replace all the broken kit when the next pandemic comes along.

I have just been chatting with someone about these figures we have been given
7000 staff in total at 10% = 700 redundancies
5000 nurses are frontline so not touched, this leaves 2000 staff at risk.
Within these there are radiographers, therapists etc who are "front line".
This means about half of the remaining staff will be made redundant. Surely this is not possible. Having said that 22% of our Supplies department have just gone, under the first wave. They have SLAs with 4 other Trusts which they must maintain at the current level as the other Trusts are still paying them the same money. So how will we fair being that we are 20% of the number of Trusts they serve.
Someone needs to do some basic thinking and maths rather than throw figures around.
Robert

No doubt your CEO will still be getting his (or, more likely I guess, her) "well deserved" bonus. Which, by the way, has to be funded somehow. But I should imagine that such essential expenditure is probably (what's that BS phrase?) ... ring-fenced.

Excuse me a minute ... I have to visit the small room. I've just felt the need for a bit of "quantitative easing"!

Very short sighted Rob. There are many ways of saving money without sacrificing ebme staff - who are usually already under resourced.

Once the staff are gone it just puts more pressure on the rest of the staff reducving morale etc, etc.

Managers who make these decisions have absolulutely no idea of the implications of either freezing a post or making a technical person redundant. They only look at the financial savings.
The person in charge of the department needs to put these implications in writing so that management are aware that they will be held responsible for their actions.
Here's a few
1. Loss of morale
2. Increase in sickness due to stress
3. Failure to comply with manufacturer's service intervals
4. Increase in equipment breakdowns which affects waiting times
5. Increase in repair costs
6. Destruction of a PPM/Service System that has probably taken
years to set up and run.
And last but not least.
All responibility for equipment failures due to lack of maintenance should be clearly passed to the management level making these decisions.

When will they get the "lightbulb" momment and see that frontline staff (so called) minus readily available kit, in the high tech world we live in now = less activity or even frontline staff + sla with oem = less activity cause it usually costs more and you get less support than from inhouse ebme. Which = more sla to cover all the activity = even less dosh to spend which = less activity and eventually the trust cant compete with others locally so they have to merge it or shut it down, eh up theres a lighbulb momment maybe eventually the people in charge will talk themselves out of jobs. Sad thing is they get shut of everyone else first then, whats the phrase rats from a sinking ship.

Hello John I am correct in saying that we should keep our departments in good order. To show the accountants our records and saving we make etc. To show them that we good QA and our end users are happy with the service we provide.

At the end of the day our services are needed but these can easily be done by a third party contractor.

I would put it a bit stronger than that, Karl:- "Enemies of the State"!

Umish, my Dear Chap. How can you do any of that once the in-house department, for all intents and purposes, no longer exists?

Surely you've heard of PFI, and all the rest?

@Graham: they're not really Managers at all, are they? These people are rarely on the scene for very long. They are not managing the situation, in the sense of taking charge of it, at all. In reality they are little more than asset strippers, whose main obsession will be to "impress" the Board (to "justify" their bonuses) before moving on to the next Target ... er, Trust.

Almost correct Geoff. No. They are not managers to us older ones, more like *ankers. The trouble is that when they do move on its usually to a higher position.

If these people were proper managers and have to make financial cuts, they would evaluate the vast numbers of non-jobs in the NHS that do absolutely nothing for patient care.

I would like to think that EBME types actually do make a difference to patient care by making sure that the equipment is in good working order, providing ordering advice and all the rest that a good department provides.

Bankers?

I'm sure we all agree with what you're saying, Graham. But I came to the conclusion many years ago that the sort of people you're talking about simply don't care.

Nevertheless, having suffered so much at the hands of such (and similar) specimens in this life (and being denied - by Rule of Law - sweet retribution so richly deserved in the here and now), I continue in the expectation that they will meet their comeuppance in the next!

I have been reading all of this with some interest.
For financial year 10/11, there will be an effective reduction in available budget to Acute Trusts of 15%. Going forward, there will be at least a 2% reduction in real money terms year on year until at least 2017.
All of this means the following:
1. Efficiencies will have to improve.
2. All positions will need to be justified.
3. There will be wholesale redundancies.
4. Services will be reduced or cut from the Acute Trusts.
5. Thresholds for treatments will be raised.
6. There will be a general move towards vertically integrated health care. This means that Acute Trusts will be more involved in the management of Community services.
7. Services will become more quality driven from a payment and assessment view point.

All of this means that there will be significant changes in the Health Service as we know it today and it will not be available for everyone that thinks they require it!!

... and the Good News is?

Sounds like a case of "what goes around, comes around" (or even, "back to the future") to me!

(there's a General Election coming up. Please cast your vote wisely and with forethought. Otherwise, mine will be wasted)

...And the Good News is....those that wake up and smell the coffee will be OK!!!
The General Election won't change anything as the NHS is in such deep kaka that it will take 5 years to get it on an even keel.
Sorry to be such a bearer of doom and gloom, but better to be a realist instead of a fantasist. Hopefully it will be a big enough shake up to get rid of all the dross out of the system.

Pity that I'm a tea drinker, then, Kawa.

But, to be honest, I doubt that the dross will be ready to give up without a fight. And (unfortunately) they are, collectively, the very kind of people who can bring the big guns to bear.

With regard to the dross, outside auditors are being brought in to many NHS organisations with a remit to find ways of reducing managerial expenditure by 30%.
Make of that what you will!!!

Here's my advice (free of charge) ... cut so-called "management" positions by 50% on Monday morning. There's your savings made, right there. I doubt that the loss of dross will be mourned ... but rather celebrated, especially by everybody else trying to get on with the real work.

But (whilst on the subject of dross) ... I was thinking more about the entrenched, long-term, types amongst the "lower ranks" who have not been noticeably productive for ... er, a number of years. Let's have a sort out across the board. Put another way, why should the tax-payer be expected to (continue to) support time wasters, often with "agendas" that are counter-productive (and very little, or in fact nothing at all, to do with the provision of public healthcare), as they drift (waddle?) on from day to day until pension time?

On second thoughts, I guess the taxpayer gets to support them anyway, whether they are "employed" in the Public Sector or "signing on" at the Job Center (so-called).

Do you need redundancies if you can just cut the bonuses???

Trouble with cutting 30% of managerial expenditure is the government indirectly put it there in the first place.
You must monitor this, says the government and a dept evolves that really has no benefit to patient care, just passed info back and forth.
We should be getting rid of all these non-jobs.

See my post of 20-Feb-10 under the "Hinchingbrooke Hospital" thread.

I have been reading this with great interest. I fully agree with Kawasaki. The situation in the NHS is dire - no general election is going to change that overnight. And it is about time there was a big shake up - make staff demonstrate their worth to the organisation. Working for the NHS is far better than working for the private sector in this current climate and their are those in the NHS that have forgotten that. We get good amounts of annual leave, sick pay, compassionate leave, emergency parental leave, there's always options for redeployment rather than redundancy - you name it the NHS on the whole is a good employer and for those that don't think so then may be they are the first ones that should go?

Welcome to the forum, Fiona.

And with such refreshing honesty! Of course it's great working for the NHS (or anywhere else in the Public Sector, for that matter - but let's stick to the NHS for now) ... for all the reasons you mention, and more!

As a non-NHS type myself (and as others on the forum will no doubt confirm), I personally get fed up with all the moaning and groaning that goes on. As I may have said before (and as you have also hinted) ... if anyone is that unhappy working in a government hospital, let them try their luck elsewhere!

And ... you're right about any possible change of government. No doubt the Great Juggernaut will lumber on regardless!

The "moaning and groaning" is all seen as being part of the job by NHS workers who believe in the importance of a national health service, currently under threat. The NHS would never have been created in the first place if not for centuries of often far more courageous dissent, which eventually resulted in trades unions powerful enough to force the provision of the vote for all. Simply walking away from problematic jobs will achieve nothing - let's stay and fight (or lose what we've won)!

I agree that there is a large amount of superflous and useless administrative work in the NHS, which to many of us clearly makes the organisation inefficient. But much of this has been deliberately put there as part of the creeping drive towards eventual privatisation - its purpose is to make staff think as customers and sellers of services. This is a part of what people are complaining about.

You're right, Geoff, working in the NHS can be great, and the job satisfaction is made all the greater when one feels one has contributed to the survival of the organisation.

An interesting thread regarding a topic which I think will become more and more prominent in the NHS over the next few years (months even, particular from 2011).

Employee's who work for the NHS (and in most public sector jobs) are onto a good 'screw' compared to our private sector counterparts, particularly in the current climate and compared to those within the Medical Engineering fields of private companies. So you are right Fiona, people should not forget that, and those who are totally clueless to that fact need to experience the real world and wake up fast.

The private companies will also be on the receiving end of the NHS financial mess.

The NHS has for too long has had too many time wasting posts, middle management tiers and generally various posts and roles which do not culminate at all to benefit patient care.

However we must not tar all managerial posts, as some are required and essential and there are people in those roles who are dedicated and well informed. There is also dead wood on ‘the ground’ amongst the so called ‘real workers’ too, and who have had their day and should leave.

The NHS is on the slippery slope and there is no return. Let’s face it, the NHS will not make another 60 years, it WILL be privatized and the implementation of Foundation Trust Status was the biggest step and clue to this fact.

We all know that once the accountants get involved (in both public and private sectors) things go downhill fast, but surely even they can see the effect these cuts will have on patient care?

Whoever gets in government in May will not be able to turn around this mess.

Perhaps the people at the top should be making sure the funds are going where they are meant and get involved in making things more efficient, this will mean staff cuts but that is by far not the first point of call.

One last un-biased thought – all employees of the public sector who have not been in the reel world should remember that they get paid regardless; they have a job regardless if any work goes out the door.

"Employee's who work for the NHS (and in most public sector jobs) are onto a good 'screw' compared to our private sector counterparts,"

They may be on a more equal footing now, but it was not so long ago that NHS techs were paid paid considerably less than their private company counterparts.
Those of us that have have been around a long time, will remember paying to have student/junior techs to go to college and get their ONC/HNC. Once achieved they promply left for industry to a better paid job.
In 1972, I left a well paid industrial job (£32 a week) to start in the NHS as a qualified tech (grade 5) on £20). Why? Because I wanted to improve myself and reach higher goals.

Very true, from a basic pay perspective. It’s only in recent years that the basic pay and other benefits/perks of the NHS have exceeded the private sector. But now it is disproportional.

However, from ‘screw’ I don’t just mean pay and benefits, I also mean ‘work’. You have to work a lot harder in the private sector than in the NHS, irrespective of pay and all that.

The NHS is like the London underground, it was ok in its day but now needs a complete overhaul to its infrastructure to meet modern day demands and to correct the years of poor direction and management. The outlook of the NHS would not survive in the private sector.

It’s frustrating that patient care is ultimately the real looser and this should not be allowed to be the case.

As for Clinical Engineering, we are front line; whichever way you look at it, but different trusts have very different views as to how big an asset we are. Without us, patient care suffers as equipment cannot be supported, staff medical training cannot occur and broken equipment cannot be turned around and downtime results in cancelled cases, etc. Can the money men not understand this, not even in baby language?

Outside companies and/or putting the equipment on manufacturers’ contract cannot be long term cost effective and the level of service in most cases will not be as good.

@brains : it's because (like politicians, rather than statesmen) they (that is, the suits, the bean-counters and their kind) tend to think tactically rather than strategically. That is, they're too busy fire-fighting, attacking the problem at hand, to have the time (or the inclination, or perhaps even the wit) to address the "big picture".

As I have observed previously, such people tend to be of short tenure. As in, "grab the money and run"!

@Graham : who* was it who famously said:-

"The past is a foreign country: they do things differently there".

(and I should know, seeing that it's where I spend most of my time)

But, on the other hand, another wise old dude mumbled:-

"Choose the future, as against the past"!

Meaning, of course, to look ahead instead of glancing back.

For what it's worth, that same sage advised (almost fifty years ago now), to "aim high - aim for something that will make a difference, rather than something that is "safe" and easy to do". In other words, find something that needs to be done, and do it. But persevere!

* It was L.P.Hartley in the opening lines of "The Go-Between"

Here's another thought for you, the NHS has been transactional in its dealings with Providers but will now have to be transformational to achieve an efficient, cost effective service.
The days of "we've always done it like this" are now behind us and we need to be looking forwards with leftfield ideas.

I've read that twice ... but still can't figure out what it is you're saying! I suspect a deliberate (attempt at a) wind-up!

No way. People on this site wind others up. I'd have never thought such a thing possible.

Geoff
I'll try and explain: all contract negotiations with Providers by the DH, SHAs and PCTs has historically been transactional; in other words, this is how much we are going to pay for this amount of activity.
With the economic crisis and decreased investment in the public sector, the negotiations will have to become transformational and look at changing the way healthcare is offered.

Do you mean that outside service providers will be able to make proposals ... and these proposals will be considered (rather than simply binned)?

Do you mean that RFP's (Requests For Proposals) will be announced, and that contracts will be awarded through a process of competitive tendering (generally, but not necessarily, to the lowest qualified bidder)?

If so ... good!

Geoff
I wasn't referring to outside service providers but current providers within the NHS: Acute Hospitals, Private Hospitals, Community Services etc.

Oh, not the so-called "Internal Market"? I thought we were talking about going forward.

"Creative Accounting" ... the same old same old.

(OK, I've lost interest now)

Still Confused. Transparency would be nice!

At £17 to £18 per hr apparently Neil !!!

Or, even ... use of the Queen's English!

Transformalisation of the transactional, this is confusing me

It's an example of Baboon Speak. We get the odd attack of it on here from time to time.

Sorry chaps, what don't you understand!!
PCTs contract with hospitals for certain levels of activity at specified prices. Up until now, negotiations were held regarding the amount of activity and the price to be charged. This is transactional.
In the future, PCTs will negotiate with hospitals, GPs and community to look at clinical pathways and how best to commission them, whilst looking to increase efficiencies and save money. This is transformational because it will change the way that aptients are treated and services run.

Change the way patients are treated, does that mean no more nurses as they will be transformed?

Neil
No it means that thresholds will be raised and pathways changed. This will mean that instead of being referred immediately to see a consultant because your knee hurts and he ends up replacing it for you (within 18 weeks), you'll be given pain killers, a bit of physio and a walking stick and told to come back when you can't hobble around any more!!! Just like the good old days.

Good job I am here then mate! as I had my knee fixed last year and glad to say no more pain, even after playing football.

Just as long as it's not the thresholds which get changed, and the pathways that get raised, or else blokes with dodgy knees will really be in trouble!


The year before last, you mean?

No last March, Lateral meniscus removed after it had split in two pieces.

Typical footballers injury (why not be like me, and just grow old gracefully).

But I'm pleased to hear that you got it sorted. Unlike my Mate Yasser at Onaiza, who was as good as crippled by the so-called Orthopaedic Surgeon there, who had earlier made light of the whole thing.

Afterwards of course is was (yet another) a case of inshallah ... but suffice to say, at age 26, it was no more football for Engr.Yasser!

Senility or Stupidity, don't know if I suffer from either or both.

Or more?