Saturday, 8 August 2009

Managers are not Leaders

The difference between the two:
  • Managers administer; leaders innovate.
  • Managers ask how and when; leaders ask what and why.
  • Managers focus on systems; leaders focus on people.
  • Managers do things right; leaders do the right things.
  • Managers maintain; leaders develop.
  • Managers rely on control; leaders inspire trust.
  • Managers have short-term perspective; leaders have long-term perspective.
  • Managers accept the status-quo; leaders challenge the status-quo.
  • Managers have an eye on the bottom line; leaders have an eye on the horizon.
  • Managers imitate; leaders originate.
  • Managers emulate the classic good soldier; leaders are their own person.
  • Managers copy; leaders show originality.

This dichotomy was modified from the one created by Warren Bennis (Bennis, Warren and Dan Goldsmith. Learning to Lead. Massachusetts: Persus Book, 1997) between managers and leaders.

The NHS is in a rut.

Its vision and direction (or Leadership) comes from discredited, incompetent politicians who have no clue about health. The orders are then sent down for the NHS managers to execute.

NHS managers are by no means the cream of the management crop to put it simply.

Strangely enough I get the feeling that some NHS managers and NHS employers realise two truths:
1) They are out of their depths
2) That leadership should come from the medical profession.

HOWEVER to fix this situation The NHS, in its current Management heavy version, is going to try and 'manage' medical leadership (in a similar way to how it 'Modernised Medical Leadership').

So it has created: NHS Leadership Qualities Framework PDF .

The framework makes for some interesting reading. Like most 'frameworks' you can tell it was created by a manager/admindroid. So something not 100% tangible (like what makes a good leader/doctor etc) gets converted into a Tick Box Exercise.

Future leaders please be aware that the NHS will require you to
Complete the NHS Leadership Module,
Sign up to the NHS Leadership Style
Emerge from the NHS Leadership Mould
Swear Allegiance to the NHS Leadership.

These guys will surely save the NHS.

To help save the NHS from ruin it would better to get rid of the managers than to create 'managed' leaders.

Friday, 17 April 2009

'Cure the NHS with far fewer managers'

Super manager Gerry Robinson thinks that we have too many mangers leaching off of the NHS. He highlights the following facts:

There are 39,900 are managers in the NHS.

There are 34,900 Consultant doctors in the NHS

That means there are now 5,000 more people employed to shuffle papers and carry clipboards than there are treating sick patients.

Not only that but the costs of these Jobsworths is increasing year on year while front line health care staff cut.

'Incomes Data Services show that chief executives of NHS foundation trusts now earn an average of £158,000. Across the board at executive level within the NHS, salaries rose by 7.6 per cent in foundation trusts, and 5.7 per cent in non-foundation bodies.'

Super manager Gerry Robinson

Welcome to the National Manager Trough Service.

Friday, 10 April 2009

The Target Culture. Are you a victim?

"Pressure, pressure, pressure" to meet the four-hour A&E waiting time target.

'Several doctors recounted occasions where managers had asked them to leave seriously ill patients to treat minor ailments so the target could be met.

One gave an example of being asked to leave a heart attack patient being given life-saving treatment.

Nurses reported leaving meetings in tears after being told their jobs were at risk after breaching the target.

And the watchdog concluded patients were sometimes "dumped" into wards near A&E with little nursing care so the target could be met. This led to delays in things such as x-rays as well as putting patients at risk'

Does this remind you of somewhere you work?


Professionals please ignore the mangers.

The public are finally waking up to their schemes.

Managers only care about the numbers.

Sunday, 29 March 2009

£15,000 a month for suspended manager

The suspended boss of Stafford Hospital, where hundreds died on casualty wards, will receive £15,000 a month while an inquiry investigates his conduct.

Wednesday, 25 March 2009

Healthcare workers beware

The number one priority for every NHS organisation must be on providing excellent care for patients.

Organisational changes, financial pressures and government-imposed targets must not distract management away from this.

If you are being harassed by some Clipboard Queen or Management Bozo remember the sad story of Mid Staffordshire...

And the universal condemnation for their success and how they achieved this.

'There is something very wrong when trusts are achieving foundation status by putting the health of their budgets over the care of their patients.' Peter Carter, general secretary of the Royal College of Nursing

Thursday, 19 March 2009

You have been warned.

Its official: Successful managers are disastrous too.

Mid Staffordshire Hospital was successful.

It met most of its targets.

It achieved Foundation Status.


Patients died and the 'successful' hospital 'caused deaths'.

Sunday, 18 January 2009

I bull**** for a living

'An NHS manager believed to earn more than £50,000 a year admitted on an internet posting that she earnt her money "bull*****ing" for a living.'

We always knew that NHS managers are a waste of space and that all they do is sweet FA.

Now in an exclusive one manager comes clean.

They are a drain on resources. They are an obstacle to clinical care. They are a drain on our taxes.

At a time when the economy is in a downward spiral and countless are being denied cancer treatments it is time to save on worthless managers and direct the money to NHS patients and front line staff.

As for Caroline Davis, assistant director of strategic partnerships at Eastern and Coastal Kent Primary Care Trust... no doubt she will leave this post only to resurface in some other guise at some other hospital trust. Wasting our taxes 'bull****ing'.

Saturday, 20 December 2008

£5m and six years later!

Idiotic NHS Manager bullies suspended a heart doctor for six years at a cost more than five million his crime:

'he gave a television interview stating that 11 patients had died because of overcrowding in a heart attack recovery ward which meant resuscitation teams could not reach them in an emergency'.

Thats how NHS Managers work. They cause dangerous overcrowding, unsafe staffing levels and then when someone speaks out for patient safety they are suspended.

Dr Mattu now holds the record for the longest medical suspension in NHS history. All for wanting to speak out for patient safety. In that same amount of time Dr Mattu has not been able to see or treat patients with heart disease in the midlands.

The NHS Managers responsible for his suspensions must be investigated and sacked as soon as possible.

Their continued presence is a danger to future patients.

Thursday, 16 October 2008

Recycling Failure

The NHS Managers get rewarded when they fail.

This is why we do not have enough cash for the life saving medications.

Early 2006 Chris Appleby was the chief executive of Penine Acute Trust, until after senior medical staff and hospital unions gave him the vote of no confidence for his poor management.

Not surprisingly he did not want to leave but had too after a damning report found his "his style of leadership has caused difficulties with some parts of the trust".

Mr Appleby eventually left with a staggering £475,000 payout.

Our money is being poured down the drain.

It doesn't end there though...

The NHS rewards Managers who fail twice more.

No sooner had Chris Appleby stepped down from one trust, he was re-hired as a temporary consultant for the Leeds Teaching Hospitals NHS Trust, a post that gives a £95,000 salary.

The NHS has too many managers and the NHS is keen on recycling failure. Not good at all.

Tuesday, 14 October 2008

Kingston NHS Shameful Sacking

Kingston has one less heart doctor to look after its patients. This is because mindless managers fired one of the cardiologists working at the hospital.

A tribunal found 'wrongful dismissal' and labelled his sacking as “shameful”.

In spite of all of this the doctor is not able to return to his old job after his former employers refused to reinstate him.

This is because the NHS is full of stupid managers.

This case has shocked even politicians too.

Vincent Cable MP said: "Last week one of his former patients, Joan Ramsey, came to my advice surgery very upset at the way he had been treated and with a petition of hundreds of residents who had found him a fine, caring doctor. They are outraged at the way unaccountable bureaucrats were able to pursue a vindictive campaign and ruin his career. They have asked me to help them secure his reinstatement subject to the final determination of the Industrial Tribunal on 30th September. I have also written to Alan Johnson MP, the Health Minister, to ask what action he proposes to take in respect of the Directors of the Trust who were party to the dismissal which the Tribunal concluded was "more reprehensible than crass incompetence."

We are still waiting for Alan Johnson to step in because Kingston Hospital needs heart doctors, not stupid managers.

Kingston Hospital bosses Oonagh Fitzgerald and Alan Pearse have been condemned for sacking Dr Roberts.

How many lives will Alan Pearse help? How many patients will he treat? In fact what is the point of having Alan Pearse around at all? Answers on a post card... or you can email your MP.

"The drafting of the charges by Oonagh Fitzgerald, the trust’s former human resources director, was damned as ‘not only imprudent but also dishonourable’."

In the current financial crisis it is clear that the NHS can not afford to have these bureaucrats on board. Its time we got rid of these pen pushers who are bad for patients.

Vincent Cable what are you doing about this?

Unfortunately for the Dr Roberts his colleagues at Kingston Hospital were to cowardly to speak out. His Union the British Medical Association was also toothless perhaps they were busy with other more important things.

Its not like we have that many heart doctors in the UK. We do however have to many failing managers.

What the tribunal report said
"We have found this case disturbing. The respondants [Kingston Hospital NHS Trust] have contrived to subject the claimant [Dr Roberts] to grossly unjust treatment.

Without explanation they have flown in the face of two elementary truths: first, that, before charging someone with breaking a rule, it is necessary to take the precation of ascertaining whether the rule exists; secondly, that it is simply improper to charge anyone, and in particular a professional person, with fraud unless there are cogent grounds.

So complete have been the respondents’ disregard for these fundamental principles of fairness and so apparently deliberate and calculated the unfairness of the entire disciplinary process, that we feel unable to exclude the possiblity that the claimant may have been the victim of something more reprehensible than crass incompetence.

As for the claimant, our findings and conclusions can speak for themselves, but he is entitled to have it expressly recorded that in our judgement the respondents’ attack upon his integrity was not merely unjustified, but shameful."

Friday, 10 October 2008

Different Types of NHS Manager

A great article from the Ferret Fancier. It neatly gives you a guide to the type of managers that you may or may not see:


The 'NHS University manager'- this is the born and bred NHS manager, trained in pure management with no knowledge of anything other than pure meaningless waffle; this results in a complete inability to understand what goes on in the real world, meaning that any attempts they make to affect change will be based on groundless management banter and will therefore only result in stifling the attempts of people who do the practical work on the NHS shop floor. They are named after the NHS University as this fine educational institution was an example of millions of pounds spent with precisely nothing to show for it.

The 'Impinging Nurse manager'- this is the extremely common sub type that plays a rather prominent role in stifling any possible progress that clinicians try to make on the ground. Invariably the weight of several packets of chips on their shoulders results in a complete inability to engage with anyone other than their fellow impingers, with whom they spend many hours snacking on lardy treats in expansive committee rooms that are only just large enough to permit the wobbling of their highly obstructive derrieres. Typically this nursing breed comes from a background of being rather useless at the real job of nursing, and from a enjoyment of bullying ones fellow employees; this lack of ability combined with a nasty vindictive streak results in a uniquely regressive style of management that many of us have the misfortune of experiencing first hand on many occasions. In their eyes the protocol can do no wrong, even when written in pigs faeces by a dyslexic crack-fuelled monkey.

The 'Donaldson'- this type of malodorous turncoat manager is named after our beloved CMO, Liam Donaldson. This type is medically trained but is very happy to sell out their own profession absolutely for the guarantee of honours, a nice office with a padded leather chair and a very occasional embarrassing appearance in public when the sh*t has really hit the fan thanks to some rather pitiful policy making. Personally I find this type to be particularly unpleasant, not only on the eye but also from an ethical viewpoint, as frankly this lot should know better. Unfortunately they are greedy egotists who have no care for anyone other than themselves, and this means that their management style always results in them enforcing the will of their master, the government. They care not for patients, the service or the staff on the ground; they are looking out for number one.

The 'Management Consultant'- this lot of smooth talking city slickers are particularly adept at being paid a small fortune for doing very little indeed, a quite remarkable talent. Despite invariably having no knowledge of medicine, healthcare and the NHS; the government seems to be rather fond of consulting these chaps using large wads of tax payer's cash. Despite the fact that many clinicians on the ground have been suggesting practical solutions to problems for years while going blue in the face, the government ignores this highly talented wealth of specialised knowledge and chooses to consult an overpriced source that doesn't really know that much about anything if we're honest. It's amazing how business seems to go ones way when one happens to donate a few pence to the political party in charge.

The 'Total Numpty'- this sub type of manager is the completely untrained breed of manager that can be found with remarkable ease in the NHS today. This type has very little knowledge of anything at all, they don't even have that precious managerial skill of being able to send you to sleep with a magic cloud of superwaffle. The NHS does have room for many types of incompetent who would not be able top find a job anywhere else, after all it is cheaper to pay them a low managerial wage than to fund their benefit claims. Strangely they do less damage than the more highly trained 'NHS university manager', as due to their complete ineffectiveness they can do no good, but also no harm.


Good manager - this exceptionally rare breed is trained in management but actually engages with staff on the ground, listens to constructive criticism and is able to learn from mistakes. Unfortunately these managers are often sacked for refusing to go along with destructive orders from above, while some of them become corrupted into the 'NHS university manager' sub type.

Ex doctor or nurse manager with no chip on shoulder and good intentions - this type is spotted in the NHS only very occasionally, a bit like the lesser spotted welsh warbler; these managers actually have the vision and insight to be able to save the NHS. It is therefore very sad to say that they frequently spontaneously combust thanks to the sheer frustration despair of having to engage with the more common forms of NHS manager. These noble managers have also been subjected to vicious smearing campaigns with little basis, and some have also been removed from office for not doing as they were told.

Thursday, 9 October 2008

The Neurosurgeon and The Croutons

In 2004 a Neurosurgeon was suspended from work for allegedly taking extra croutons.

Hospital bosses promptly suspended him.

Three operations were cancelled.

Thats three people who needed neurosurgery.

Three diseases that needed treating.

Which genius took the decision to send the neurosurgeon home? Which NHS Manager made the smart move to suspend the surgeon from work? We'll never know. Thats what the jobsworths do, they make bad decisions and then hide. Never accountable. Never appologetic. Who are they?

Obviously someone who does not care too much for patients. There are ways with dealing with situations like this... ways that do not involve cancelled operations.

The NHS guidance is clear. Suspension of clinical staff must be a last resort, and when patient safety is an issue.

So what did the hospital, Queens Medical Centre in Nottingham have to say?

“A consultant was suspended on Wednesday following an alleged incident at the hospital which did not relate to any patient or another member of staff."

So the three patients who had their operations cancelled were not affected? What about his patients waiting to see him in clinic? Were they too not affected?

There are fewer brain surgeons in Britain than anywhere else. We probably have more managers than anywhere else.

Patients' groups were also stunned. The Trigeminal Neuralgia Association said: "This does seem extraordinary. Any patient would be astounded."

Not surprisingly the politicians did not get involved with a problem they helped create, though it was picked up by the House of Lords.

The NHS is failing. Incompetent managment is rife. It is only the patients who will suffer.