Monthly Archives: April 2025

we are not numbers

I had a relatively quiet week at work, off the wards, so tackled my to-do list. It’s a long list. I chose my least favourite task, writing the ward rota for the Respiratory Consultants. Why is a Consultant doing this tedious task, you may ask? This is a symptom of more than a decade of underinvestment in the NHS and the false economy of cuts, and more cuts, to a dwindling admin support team, resulting in more and more tasks being piled onto the clinical workforce. It would have been unthinkable to expect a Consultant to write a rota ten years ago. From a public and organisational perspective, it makes no sense to have employees who are paid well for their expertise and experience, performing admin tasks. Whilst I wrestle with excel spreadsheets, and attempt to solve hierarchical constraints problems, I am not delivering or improving patient care. Not only this, an undervaluing of admin in the NHS has led to low staff retention and poor patient experience. False economy is a feature of the modern NHS. Next time a politician talks about ‘cutting backroom staff’, remember that the work of the backroom does not go away, it just lands on the desk of the front line staff.

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Tired of being tired

I’m sure I didn’t used to get so tired. My 40 something year old body just does not keep its’ charge as well as it used to. But it could perhaps be forgiven as it had to cope with 12 consecutive days at work with a 12 hour Sunday shift thrown in for good measure. There are well documented adverse health effects of working extended hours including: depression and anxiety; sleep quality; physical injury; coronary heart disease; and some cancers. There are also concerns about decision fatigue setting in by the end of a 12 hour shift. This has not been adequately studied, but it certainly feels true.

“Tired” by Sima Jo Benson.

It’s not merely long hours that have contributed to my fatigue. The constant chaos of the NHS is draining, driving many colleagues to retire earlier than planned. I attended a Kafkaesque meeting in which the first half was spent discussing the dictat that we find ways to save money. We are provided with no data, no suggestions, no project management support. There is also zero focus on improving patient care. Just save money. The second half of the meeting was spent looking at recent staff survey outcomes which are the worst they have ever been, showing staff feel unable to provide high quality care, do not feel in control of their services, and do not feel supported in their improvement plans. We were asked to explain why we are so unhappy and what we propose to do about it!

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Euphemistically speaking

This week Labour announced ‘reforms’ to the benefits system as part of Rachel Reeves’ Spring Statement. Reform only ever means one thing in politics: cuts. The narrative from Labour is that they are having to make ‘hard choices’ because the Tories left everything in a mess. ‘Hard choices’ is another euphemism, parroted by the cabinet to justify economic violence towards ill and disabled people. Attempting to frame this is a moral crusade to get people back to work must surely leave a bitter taste in the mouths of any Labour ministers who still have a conscience. As NEF has shown, the widely reported numbers of £4.8bn of cuts leading to 250,000 more people being pushed into poverty, including 50,000 children, were actually an underestimate. The government have attempted to hide the truth using accounting tricks, factoring in a never implemented policy called the Work Capability Assessment which would have made it harder for people to qualify for a higher rate of universal credit on the basis of illness or disability. It was never implemented, so whilst it may make sense on spreadsheets, it is irrelevant to actual people, living on very little in a cost of living crisis. NEF analysis shows that the cuts will hit ill and disabled people by almost £2bn more than reported and could see around 100,000 additional people pushed into poverty.

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