If the NHS had more managers, would performance improve?
In this article, we discuss whether the NHS has too many managers; and if the NHS had more managers, would performance could improve? We mainly focus on hospital managers. But the principles also cover primary care, mental and community health, and all parts of the NHS.
Does the NHS have too many managers?
No. In fact, many people feel there are too few.
Why? In the wider UK workforce, most large organisations – e.g. JLR or Marks and Spencer – are comprised of 10% management. In the NHS it is 2%. So much of the ‘management’ is done by doctors and nurses – often not very well.
The common counter-argument is that if we had ‘less managers’ that money could be used to employ more ‘front-line’ staff (doctors and nurses). It very unlikely that more doctors and nurses would focus on the areas of inefficiency described below.
If the NHS had more managers, would performance improve?
Yes, very probably. How? There should be ..
- Less lost/cancelled operating and procedure lists, clinics
- More senior involvement in ward rounds, encouraging discharge and flow
- Annualised contracts
- Improvements in processes
- Better information technology (IT). It’s poor in most of the NHS
- Better use of NHS facilities on Friday afternoons, weekends/bank holidays etc.
Definition of a NHS manager
One of the reasons why there is confusion and debate regarding this issue, is that there is no simple definition of an NHS manager (or any manager actually). Many ‘official’ lists of managers include administration staff (secretaries, receptionists, ward clerks etc).
Summary
We have discussed if the NHS had more managers, would performance improve; and whether the NHS has too many managers. MyHSN thinks a. too few actually, and b. yes. We hope this has been helpful. What do you think?
