primary_care_training_pulse

Asking too much

News and Comment from Roy Lilley.

An organisation can only travel at the speed of its people, deliver what its people are trained to do and only what they’re willing to do.

The last seven-odd years have been super-tough for the NHS.  The legacy of a forgotten generation of frail-elderly has caught up with us. 

Hand-to-mouth, flip-a-coin-funding.  Political bewilderment  The sky is dark with chickens coming home to roost.

We’ve no money, we’re running short of recruits, patients queueing around the block.  It’ll get worse.  

Huge pressure… everyone working at the ragged edge.  How do we show we care… say ‘thank you’ for what you do.

Here’s one solution;

‘… as our way of saying sorry about not treating you very well we are going to give you a pay rise.  We are going to tell the press it’s a lot of money.  It isn’t…  and, to help pay for it, we are going to cut your annual leave…’

That’ll work… won’t it?

After months of secret negotiations the cat is out of the bag.  According to the Guardian… 

‘The government is set to offer around 1 million NHS staff a 6.5% pay rise over the next three years… insisting that [staff] give up a day’s holiday in return…’

You couldn’t make it up.  Maybe they have?  

First; no one seems exactly sure what the national pay bill is.  The National Treasure, Nigel Edwards at the Nuffs, says the holiday sacrifice is worth a pay-cut of 0.4% to the individual.

Next; no increase since 2010… roughly, a 14% cut in real money terms.

Third; the headline, ‘6.5% pay rise’.  It is actually 3% in the first year and then 1-2% in the following two years… inflation will erode its worth.

Last; the uplift is not universal, it’s weighted to benefit lower paid staff.

The plans aren’t agree and won’t feature in Chancellor Hammond’s Spring Statement.  Mmmm…

It is inconceivable unions will agree.  Three days leave, in exchange for a few quid, is a mugging; ‘… give me your phone and I’ll give you back your trainers.’

The Treasury said, the NHS can’t have any money without improvements in productivity. That’s fair.

Here are some factoids…

  • Funding for health care as a proportion of GDP is forecast to fall from 7.6% in 2009/10, to 6.8% by 2019/20. 
  • Growth in health spending won’t keep pace with the growing, ageing population.  
  • Spending per person will fall by 0.3% in 2018/19. 
  • From 1948 to 2010, the number of patients has doubled and the number of beds halved. 

NHS’ productivity increase is about 1.2% a year and the wider, UK economy, under one percent.  As the FT reported;

‘The most recent growth in [UK] productivity was due to the number of hours worked falling rather than an acceleration in the growth of output….’

The NHS is doing better than the rest.

You can see what’s coming.  If you can’t get outputs up, get the same stuff done by fewer people… call it productivity.  It’s not.  It’s more work for fewer people.

Lose 3 days leave… who cares?  Go sick – get them back. 

Here are a few more things to think about…

Business productivity is around 20% lower than pre-crash 2010.  

In the NHS it’s up.

Companies, going broke, have invested too little.  

So has the government in the NHS but it’s doing better.

Productivity is measured weirdly – dividing GDP by the number of hours worked… potty.  

High-value banking at the top end, versus high labour-intensive, caring for your granny’s bottom end.

Low interest rates have made junk businesses seem profitable.  

When local health economies run dry, NHS Trusts are surcharged punitive interest rates.

Businesses have hung-on to unproductive workers, distorting productivity numbers.  

The NHS does not have enough workers.

If Unions agree to this pay deal… stop your subscriptions.  If hand-wringing Boards, grizzling about how they value staff, agree to this… take them to a quiet corner and put them out of our misery.

We go to work to earn the money to pay for the house we leave behind most days, to put the food on the table for the family we hardly ever see, to drive a car that sits in the carpark all day… the least that could happen, when we are working, is we are valued, prized and treated fairly.

Just who is asking too much?

—————————-   

 Contact Roy – please use this e-address

roy.lilley@nhsmanagers.net 

Know something I don’t – email me in confidence.

Leaving the NHS, changing jobs – you don’t have to say goodbye to us! You can update your Email Address from the link you’ll find right at the bottom of the page, and we’ll keep mailing.

———-
Disclaimer

Reproduced at thetrainingnet.com by kind permission of Roy Lilley.

[siteorigin_widget class=”WP_Widget_Recent_Posts”][/siteorigin_widget]

Previous Posts

A wooden bench on a grassy area overlooks a large body of water, with mountains visible in the hazy background.

Headline.

Streeting’s latest NHS workforce plan ignores systemic issues, focusing on recruiting more GPs despite the strain on resources. The real solution? Shifting care to community nurses, who offer better value and flexibility.

Read More »
A modern white hospital building with multiple windows stands in front of a taller white skyscraper, under a blue sky with clouds, partially obscured by a green hedge.

Think again.

Think “hospital,” and you picture nurses, ambulances, or stethoscopes—not someone hunched over a desk solving the NHS equivalent of a mathematical enigma. Yet, administrators are its hidden heroes.

Read More »
A man sits on a gray couch, talking on his smartphone while engaging with his laptop, the backdrop of a brick wall emphasizing the modern workspace vibe—a scene possibly oriented towards primary care training for GPs.

Forever!

I’m sitting at the computer screen, wondering if it’s worth taking up your time. Charmer’s speech yesterday—three commitments, five missions, six milestones—offered no clarity, just a rat’s nest of priorities.

Read More »
A woman sits cross-legged on a rocky riverbank, meditating with her eyes closed. She wears a white top and gray pants, much like medical staff in moments of calm between responsibilities, surrounded by greenery and the soothing flow of the river.

Fat chance!

Health Secretary Wes Streeting faces ridicule over a ban on sugary food ads before 9 PM, accused of ‘nanny-state’ tactics while failing to address deeper causes of childhood obesity.

Read More »
A doctor holding a large hourglass is surrounded by medical graphics, illustrating NHS capacity and patient inflow, highlighting the critical role of GP training in navigating a hospital's dynamic environment.

It might just be possible!

Ancient China’s gifts include silk, spices, and calculus. Applied to the NHS, calculus explains how waiting lists grow due to inefficiencies. Fixing productivity, not just efficiency, is key to improvement.

Read More »
A yellow and black butterfly with intricate patterns rests on a plant amid green foliage, offering a moment of tranquility reminiscent of nature's gentle touch in healing settings like those embraced by dedicated NHS doctors.

Butterfly.

The NHS faces chaos as budget cuts and aging demographics collide, with ambulance services reducing capacity amid rising demand. Like the butterfly effect, small decisions now amplify systemic crises.

Read More »
Lindsay Dubock stands at the front of the room, addressing a seated audience with dynamic insights in a conference setting. Engaging slides from The Training Network illuminate behind her, enhancing the training experience.

The General Practice Toolkit

Lindsay delivered The General Practice Toolkit to over 100 NHS Primary Care delegates at Bromley Court Hotel, equipping them with practical strategies to enhance mental health, resilience, and holistic patient care.

Read More »
A rainy city street with a dome-topped cathedral in the background is surrounded by tall buildings. Amidst the bustle of black cabs and red buses, doctors hurrying to provide primary care walk alongside others with umbrellas on the slick pavement.

Put your money on them. 

Drivers spend two days a year waiting at red lights. Meanwhile, 4.2 million UK people claim health-related benefits. Tackling these challenges? Focus on trust-building, holistic care, and our GPs.

Read More »