NHS middle managers too comfortable to take top jobs “Kafkaesque regulation and rising patient expectations mean that managers and doctors opt for an easier life in less demanding roles”… political courage is needed.

The reporting and leading article in The Times 11th May miss one or two points, but the main point is that political courage is needed, (and currently absent) . There is no belief in management or medical staff that the Health Service they work in (English, Welsh, Scots, Manchester or Irish) is sustainable. They see the paradox of being honest enough to support the workforce, but dishonest to the public. Denial by politicians who are aware of both means they must move on quickly (2 years is average) before any long term implications of their actions are evident… It appears managers have matured and realise that, at the top, the risk is much higher.. There are few companies that will accept them after a career in the Health Service, so this is a sensible risk-averse decision making process. The Times Leader 11th May (Hospital Pass ) ends with “…The chief executives’ complaints are symptoms but not the disease. The NHS needs more than good management; it needs a revolution in its methods of provision. This will require political courage and professional consent. It is not a transformation that can be managed into being.” We could start with GP (De-?) Commissioners being honest about rationing and what will not be available..

Chris Smyth in The Times 11th May 2016 reports: NHS middle managers too comfortable to take top jobs “Kafkaesque regulation and rising patient expectations mean that managers and doctors opt for an easier life in less demanding roles”…

NHS middle-management has become so comfortable that almost no one wants to do the difficult job of running a hospital, departing chief executives have warned.

Better pay and working conditions for those in the middle, coupled with the “ritual humiliation” of those at the top by regulators, have contributed to a shortage of good candidates to lead NHS organisations, according to 12 former bosses. They were interviewed for the King’s Fund think tank and the hospitals’ lobby group NHS Providers.

One in seven of the top jobs in hospitals are unfilled as middle managers refuse to take the step up, put off by increasing pressure that means the average chief executive now lasts only a couple of years in the post. Patient care will suffer because “there simply isn’t enough talent to go round”.

Kafkaesque regulation and rising patient expectations mean that managers and doctors opt for an easier life in less demanding roles, they said.

Jeremy Hunt, the health secretary, has questioned why dozens of NHS chief executives earn more than the prime minister. Bosses say that lower-level managers dodge the “fat cat” headlines. More than 10,000 senior managers are paid an average of £78,000, while board-level pay can top £100,000.

Catherine Beardshaw, who recently retired as chief executive of Aintree University Hospitals, said few of these people wanted to apply for top jobs. “People I’ve talked to at director level have said, ‘Well, why would you? It’s a hard life. I’m getting well paid at the moment so why should I put my head above the parapet?’” she said.

Sir Robert Naylor, whose departure as head of University College Hospitals London had to be delayed because no suitable candidate could be found to replace him, said the job had become more precarious with social media scrutiny, a lack of money and oppressive regulation.

Younger managers “get two-thirds of the way up the ladder and say, ‘I don’t really want to be a chief executive. I’m being paid a decent salary; do I really want to spend 24/7, with all that exposure, being a chief executive?’ ” he said. “Work–life balance is much more important now than it was in my day, and middle management jobs are relatively better paid.”

Several of the bosses expressed disappointment that so few doctors and nurses wanted to run hospitals.

Tim Smart, who took over at King’s College Hospital after a career with BT and Shell, said: “I feel the fact that I became chief executive of King’s is a bit of failure on the NHS’s part. Doctors and nurses are among the most talented professionals in the country. So why are there not 30, 40, 50 of these people running the big organisations?”

What sort of evidence do Trust Boards and CCGs listen to? The Single Interest Pressure Group and levels of evidence. Do Commissioners and Trusts have policies to cope with them? Case studies are not valid evidence.

Should patients risk being on the list of GP commissioners?

Rationed – Start of cheaper technique for breast cancer is delayed in UK despite adoption elsewhere. GP commissioners should be demanding intra-operative radiotherapy.

Are Commissioners willing to provide proper maternal perinatal psychiatric care?

The “biggest privatisation yet” – CCGs told to delay signing £1.2bn deal on cancer and end of life services

Continuing Health Care funding needs to be rationed honestly, universally, and overtly. The only fair way is by a third party without the Perverse Incentive to refuse..

Decision making in Orthopaedics. A reflection by proxy from Mrs Charnley. It is decentralisation that is leading to irrational decision making….

Women denied IVF as 80 per cent of NHS trusts ration fertility treatment

Financial meltdown. Wait for the knee-jerk response..

 

 

 

 

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