Saturday, 3 January 2009

The management must take the blame

It's hardly fresh off the press, but the fact that so much money is being continually wasted on paying extortionate rates for agency/locum staff is incredibly sad. The Times wrote on this last year and at that point at least a billion pounds a year was being spent in this manner.

This year's news if full of more of the same. Apparently at the same time thousands of nurses are fleeing for a better quality of life abroad. This is just plain stupid for so many reasons. The blame should be laid firmly at the door of the short sighted fools who have the power to change this, these fools can be found either centrally at the Department of Health or locally at a hospital near you.

This is not just a problem for nurses, the very same problem exists for doctors, it's just because of the weakness of our union hospitals routinely run short of doctors without bothering to even hire in the agency staff, hence nowhere like the money is spent on agency/locum doctors I would suspect, despite the demand being pretty significant.

This problem could be avoided by some very simple measures and it would also improve the conditions for everyone working in the NHS, leading to better performance and staff retention. It's amazing what could be achieved by proper planning and treating people well, as opposed to bullying the intimidating to get what you want.

The solution would involve employing more staff than one actually needs, assuming everyone stays fit every day of the year, because the current system of employing the bare minimum is bad in terms of safety and bad in terms of staff morale. In fact it is much cheaper to employ a couple of extra nurses/doctors full time to cover for sickness and other absences than it is to employ the bare minimum, then hire in the expensive agency staff when people inevitably get sick. Also remember that people are more likely to get sick and stay off work if they are less well backed up at work in terms of having a bit of slack in the system.

I have seen the solution work very well abroad, extra doctors work for short periods where they only cover other gaps in the rota, it means that all the rotas are fully staffed all the year round, everyone stays happy and nowhere is dangerously short staffed. Contrast this to the situation in the NHS where there is no slack at all to cover for junior doctor absence, meaning that patients suffer due to the lack of continuity and that doctors become exhausted because they are constantly doing the job of two or three.

It's hardly rocket science is it. One can plan for the fact that a certain percentage of staff will be away from work a certain proportion of the time because of sickness et al, hence one can employ a certain percentage of extra staff to cover these very predictable absences. This keeps everyone happy and provides a better service for patients.

However it just doesn't seem to happen as we have a management hierarchy with the combined brainpower of a Land Rover squished hedgehog. It would involve planning ahead, making some simple calculations and the hardest thing of all, actually working with people and cooperating with staff to achieve a goal. The management of the NHS would rather spend a billion to save a hundred million, they would rather bully than cooperate, and for this reason things keep going backwards. No wonder doctors and nurses are fleeing the NHS in droves.

1 comment:

Nurse Anne said...

You are absolutely correct. It is cost effective to staff a hospital well and provide in house coverage to deal with absences and sick time.

California found this out when they were forced to institute safe nurse patient ratios and construct in house float pools. Management fought against it being forced into effect, but when it did come into effect and they saw that they were saving money they shut up.