From our new management consultancy correspondent:
This certainly seems to be true, and is clearly taking a toll. So the questions should be asked who was the idiot that organised it like this, what can be done to reduce the load, and how can that be improved quickly.
12 hour shifts.
A 2 shift 12 hour day is only achievable if you can take a lot of down time during the 12 hours. PPE makes that very hard. In any occupation 12 hours straight work (OK 11 with breaks) is tough. In PPE its going to be a killer. So why arent they doing a 3 shift 8 hour day? 3 x 8 hour shifts is the norm for manufacturing.
The standard Junior Doctor contract is for a 40 hour week including breaks. 8 hour paid overtime takes it to the working time directive 48 hour limit. So are all the doctors and nurses smashing through the working time directive, putting in 20 or 30 hours overtime, or are they doing 4 days on to get to 48 hours, then a couple of days off. Who organised this shift system?
They spend a lot of time talking to relatives.
Yes, in an ideal world maybe the doctor shoud do that, but it is mostly not medically skilled, and it is stressful as hell. Putting soemone in to do the patient updates could save a few hours per doctor per day, which is equivalent to adding 25% to the number of available doctors. Every ward should have a relative liason worker, who does all (or almost all) of that stuff.
Turning patients takes a huge team.
6 to 8 doctors and nurses to turn a patient over, many of them need turning each day, this is physically exhausing work and unusual to Covid. But the skill set is not much medical. THere are a bunch of tubes and masks and stuff that need careful handling, and once over several checks need to be done. But the actual lift up over down bit, is all muscle not medical. So each ward should have a team of half a dozen lumps from the local gym to do that bit.
OK 7 extra people per ward per shift, maybe an extra half billion quid needs spending to get through this. Frankly in the scheme of whats been going on, that is small beer who cares. And we get back less exhausted, less stressed, frankly better doctors and nurses. And if the doctors and nurses actually all are banging in the overtime to meet the load, it wouldnt even cost that, might even save money.
What we have here is a classic case of highly skilled people doing low skilled work. Managements job is to reduce that, because it fries the high skilled and is an incredibly inefficent use of resources. I suspect that its all down to management, becasue every doctor or nurse you meet seems to want to do their best, but the middle managers are all busy buggering up their lives writing and taking left handed diversity and inclusion courses.
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A week or so ago, you mentioned the massive paperwork necessary to actually hire someone.
So while this suggestion may actually make sense, I'd argue that it's bureaucratically impractical.
‘ I suspect that its all down to management...’
Exactly. In the NHS there is none.
Or too much
Of the wrong type.
Don't you dare oppress us left-handed types! It is bad enough being branded an Other and being confused with the Left. Not to mention the discrimination we face in everyday products.
It's a sinister conspiracy.
"What we have here is a classic case of highly skilled people doing low skilled work. Managements job is to reduce that, because it fries the high skilled and is an incredibly inefficent use of resources. I suspect that its all down to management, becasue every doctor or nurse you meet seems to want to do their best, but the middle managers are all busy buggering up their lives writing and taking left handed diversity and inclusion courses."
I did some support on a consultancy job around district nurses. I'm a software consultant, but the management consultants brought me in to discuss ways to implement work with software.
The management aren't really management. They're overpaid bureaucrats. Part of the problem is how massively over-centralised everything is. Like we suggested getting the nurses sat navs because so many appointments were missed by the nurses getting lost. One of the guys calculated a saving within 2-3 months, conservatively. In a small business, a manager would get in his car that lunchtime, take you to Halfords and just buy them. In the NHS, you can't do that. It has to be on a product catalogue of approved items. So you then have to jump through tons of bureaucracy to get it onto the catalogue, and of course, you'll pay 3 times the Halfords price because it goes through multiple levels of suppliers.
I'd go as far as to say that this leads to the NHS getting drongos in management. If you're motivated by improving healthcare, you'll go work in management for Nuffield, Virgin or a drug trials company.
Going to Halfords is SO yesterday. They've all got GPS on their phones, and of course, the people who need them don't get their phones paid fo, not like the senior 'managers'.
Question: Wy is the NHS like a University?
Answer: Because they are bunches of clever, talented, people run by rather too many total fucking morons.
This was back around 2008. The point was more that if you showed managers a £250 investment in a small company that would conservatively pay back in 3 months, they'd bite your hand off. Which is why all the cabbies and delivery drivers had them.
If you're driving you shouldn't be using your mobile 'phone: satnavs with large screens (for the occasional really fast sideways glance) are safer
Or just teach the bloody idiots how to read a map. I mean, seriously, how do they manage to get out of school without being able to navigate the world around them?
Vast swathes of people have no idea where they are now when driving. They just follow the sat nav. They have no mental map in their heads of where they live and where the place they are heading for is in relation to that, its just a complete blank.
This episode is an inherent problem of gov't bureaucracy. Yes, in a private company, a manager would just go to Halfords and buy a solution. (And, at a company of any size, he would still have to file paperwork to justify the purchase if he wants reimbursement.) Indeed we don't want an NHS manager doing that with taxpayer funds. If it were that easy, many managers would get in their cars that lunchtime and seek solutions at the race track.
It isn't that much different if you're dealing with large corporations. Try getting your one-man-band or small consultancy onto the approved supplier list for one.
This was trivial when I started out and even when I left a consultancy to go free-lance. Microsoft did want some details before I could consult there. Then others' contracts weren't renewed and they sued for unemployment benefits. Now, with California's Assembly Bill 5, it's illegal (rolled back a little by referendum so that the Uber cars can get back on the road). We are all "employees" with rights, not including find a new client when the work is done! And Biden wants to take this national.
The situation regarding employees and consultants is very different in the US, as I found when I worked there.
If that was years ago, then what I am saying is that it has become different now from what it was then.
"Each ward" would result in shitkickers outnumbering the medics two or three to one. The liaisers and lifters would spend about one hour a day doing useful work and the rest on Facebook.
Just like some American public schools.