"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Friday, 17 September 2010

30% cut in NHS administrators

Yup, that is Lansley's plan, the clueless idiot. Why do I say he's clueless? Well, there is always some administration needed (like ensuring patients' notes are in the right place, that diagnostic tests are done at the right time and the results are on the doctor's desk when the patient visits) so cutting administrators is just plain daft.

For example, I attended a meeting at my local hospital a couple of weeks ago and they presented the results of a study they were doing on "patient pathways". Basically they performed some case studies of several patients listing the time that was taken for various activities: consultant visits, treatments, nurse contacts, meals sleeping and just waiting for one of the other activities. The last activity: just waiting, took the majority of the time. length of stay in hospital is directly related to costs: each hospital bed is an expensive resource and a patient in a bed waiting for treatment/tests/consultation or discharge is preventing another patient using the bed. The presenter gave an example of a patient having a blood test and pointed out that if this happened after four then the results would not be available before the consultant went home, meaning that the patient would have to spend another night in the hospital.

All of this is project management: you need someone to make sure that tests are done promptly, and that the results are available at the right time. Yes, you may also persuade consultants to change their working patterns but this is a management issue.

So now we have Lansley dictating that management is going to be cut by 45% and administration by 30%. How the fuck does he think that can be done? A good manager saves money, s/he makes the system efficient, cutting management by some arbitrary figure is nonsense.

So I was rather interested to see that junior doctors spend more time on administration than on formal training. With the diktats from Lansley about cutting management and administrators, junior doctors will find that they will have far more non-clinical work to do. And, of course, that will increase the drop-out rates (one in four currently).

Have a read of this doctor's account of the administration that she was required to do, and I challenge you not to think "but surely there is an administrator who can do it for you?"

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