Junior Doctors' Pay Claim Poll
Poll: Junior Doctors' Pay Claim Poll
Total Members Polled: 1014
Discussion
borcy said:
I thought it might be the case.
I wonder how many managers need to have a clinical background for some depts, I'd seen a few jobs adverts that don't really seem like you need to have a clinical background but it's a requirement. I wonder how many are written that way as to create a pathway for internal candidates rather an objective view?
If you've got good people who you want to develop you can curate their career and make opportunities for them. In some cases a job spec can be so tightly defined that only a limited number of candidates can apply. This can work in a very positive way and I can think of many first class clinicians and managers who were talent spotted, encouraged and developed over years and decades. One of the best managers I worked with (an umbrella type) started as a cleaner; then was a HCA; did nurse training and ultimately became a ward manager. There wasn't a single job amongst the people he managed that he hadn't done himself. This gave him qualities of empathy and credibility between him and his staff.I wonder how many managers need to have a clinical background for some depts, I'd seen a few jobs adverts that don't really seem like you need to have a clinical background but it's a requirement. I wonder how many are written that way as to create a pathway for internal candidates rather an objective view?
More commonly the behaviour of managers is similar to courtiers. It's not unusual for ambitious managers to drag a coterie of sycophants through the path of promotion behind them. Very commonly when an exec is appointed to a new Trust they will populate senior positions with trusted colleagues from a previous posting.
All of this is a reason why the managers in NHS are almost all white despite being a very diverse workforce.
Up to a point it's desirable that staff are led by members of their own tribe. The obvious non clinicians are those in post in IT, HR, Finance and Estates.
oddman said:
borcy said:
I thought it might be the case.
I wonder how many managers need to have a clinical background for some depts, I'd seen a few jobs adverts that don't really seem like you need to have a clinical background but it's a requirement. I wonder how many are written that way as to create a pathway for internal candidates rather an objective view?
If you've got good people who you want to develop you can curate their career and make opportunities for them. In some cases a job spec can be so tightly defined that only a limited number of candidates can apply. This can work in a very positive way and I can think of many first class clinicians and managers who were talent spotted, encouraged and developed over years and decades. One of the best managers I worked with (an umbrella type) started as a cleaner; then was a HCA; did nurse training and ultimately became a ward manager. There wasn't a single job amongst the people he managed that he hadn't done himself. This gave him qualities of empathy and credibility between him and his staff.I wonder how many managers need to have a clinical background for some depts, I'd seen a few jobs adverts that don't really seem like you need to have a clinical background but it's a requirement. I wonder how many are written that way as to create a pathway for internal candidates rather an objective view?
More commonly the behaviour of managers is similar to courtiers. It's not unusual for ambitious managers to drag a coterie of sycophants through the path of promotion behind them. Very commonly when an exec is appointed to a new Trust they will populate senior positions with trusted colleagues from a previous posting.
All of this is a reason why the managers in NHS are almost all white despite being a very diverse workforce.
Up to a point it's desirable that staff are led by members of their own tribe. The obvious non clinicians are those in post in IT, HR, Finance and Estates.
I know few people that have worked with the NHS and then moved back to other highly regulated industries. Not a massive sample but they did mention common themes; a fierce protection of their empire, owning up and having a 'just culture' was completely alien and a fair bit of eye rolling when trying to bring in ideas that where fairly new to the NHS but had worked elsewhere.
The problem with very tight job specs is that you end up, as suggest, with ducks picking ducks it really narrows down who you can put into the post.
Edited by borcy on Saturday 9th March 13:13
oddman said:
Up to a point it's desirable that staff are led by members of their own tribe. The obvious non clinicians are those in post in IT, HR, Finance and Estates.
And that's how you end up with IT systems clinicians hate, allocation of resources to projects that have little clinical impact or inadequate investments in things like theatres.Clinical led decision making is vital at every stage, in particular its mad to procure an IT system if the decision is made by people who don't know the difference between CRP and C-ANCA.
The challenge is most clinicians have zero idea about basic management process, most only understand heroic leadership, and very few have ever implemented or deployed any large scale change projects. All of this is possible to learn but unlike academia or even teaching where you now have specific job roles that offer 'protected' time for clinicians to learn and still do clinical training, for leadership it all has to done in your own time, and personally I've found NHS 'speicfic' leadership courses to be pretty weak as others have said, accountability/performance management is something alien to many in the NHS.
The most damaging part of industrial action I worry about is the future, if clinicians involved in helping to steer the right course for strategy/leadership is seen as vital, where are the future clinical leaders going to come from??
To most juniors doctors today, the leadership in the trusts is the same as the leadership in government, its them versus us. Its a truly sad state of affairs when a whole generation of future consultants have already essentially disengaged with taking an interest in leadership/management of the organisations they will end up working in for 20 years+ as consultants
.Edited by gangzoom on Saturday 9th March 16:46
Dixy said:
Whilst I think that the consultants are the second most important people in the hospital, a great CEO should make the whole thing function.
Couldn't agree more, our current CEO is simply a beacon of effctive visible and servant leadership. Frankly I don't know how they do it, I get a fraction of emails/demands they do and at times I'm literally running like a crazyed hamster trying to escape a YouTube Minecraft maze........That's before you sit down and reflect on essentially the impossible job of trying to deliver care in the tightest financial envelop for a long time. The difference been is failure to deliver an effective strategy means potentially real life people coming to harm, and staff having to deal with increasing risk, all the while been mindful of which way the political wind might blow.There is are no options for buyouts or focus on different markets, essentially have to remain eternally positive, somehow, you can enable transformation change to be delivered safely and at pace. Consultants can easily earn more than the CEO through doing WLIs......I'm not sure the attributes needed to be an effective NHS CEO for an acute trust, but it's a job most people wouldn't want to even consider let alone do when you really sit down and work out the implications of the job.
Edited by gangzoom on Saturday 9th March 16:48
Edited by gangzoom on Saturday 9th March 16:48
gangzoom said:
Couldn't agree more, our current CEO is simply a beacon of effctive visible and servant leadership. Frankly I don't know how they do it,
We had one like that. Kept themselves on the nursing register and put themselves on the bank. Used to do an average of a shift a week usually as an HCA. Could pop up anywhere day or night. Proper champion of good nursing care and expected others to match his commitment. Respected if not univerally liked. A good ally and not a doctor hater. More often my experience is CEOs flitting from one photo opportunity to the next in the 'halo' services and never to be seen in the engine rooms of the Trust.gangzoom said:
I'm not sure the attributes needed to be an effective NHS CEO for an acute trust, but it's a job most people wouldn't want to even consider let alone do when you really sit down and work out the implications of the job.
That's why most of my experience is of managers who are a slightly less malignant version of the low calibre, doctor hating managers at the Countess of Chester. I think a great many are frankly deluded and insightless about the gap between their abilities and the role. Some are essentially benign and evangelical ('I want to make a difference') others are frankly psychopathic (enjoy the pursuit and exercise of power). The behaviours exhibited (bullying and favouritism being the most common) are a mark of their fundamental lack of guiding principles and inadequacy.Interesting as it may be the digression into the quality of management in the NHS has little to do with the issues affecting junior doctors.
Although it is hard to escape the fact that almost all NHS staff have to follow some form of regulatory control, with the exception of non clinical managers (unless they were clinical and retained their registration) which has to be wrong - maybe a topic for another thread.
Although it is hard to escape the fact that almost all NHS staff have to follow some form of regulatory control, with the exception of non clinical managers (unless they were clinical and retained their registration) which has to be wrong - maybe a topic for another thread.
gangzoom said:
oddman said:
Up to a point it's desirable that staff are led by members of their own tribe. The obvious non clinicians are those in post in IT, HR, Finance and Estates.
And that's how you end up with IT systems clinicians hate, allocation of resources to projects that have little clinical impact or inadequate investments in things like theatres.Clinical led decision making is vital at every stage, in particular its mad to procure an IT system if the decision is made by people who don't know the difference between CRP and C-ANCA.
Edited by gangzoom on Saturday 9th March 16:46
My experience with Drs is they don't like the word no. Experts in their field but often have very little understanding of how other areas work and their needs.
Perhaps harsh, but probably more that they don't want to step into areas where they aren't the expert in the room.
sawman said:
Interesting as it may be the digression into the quality of management in the NHS has little to do with the issues affecting junior doctors.
I would disagree. The job of been a doctor is fundamentally ‘fun’ for those who choose to go into the profession, the job satisfaction is second to none, the security of employment is unheard off in any other industry, and the pension isn’t described as ‘Gold plated’ for no reason. The comradery of junior doctor training was the thing that kept me going when doing 80% banded jobs, I’m just not sure it exists in the same way these days .The issues that face current junior doctors go far beyond pay, there is no more ‘team’ spirit due to a need to complex rota, even in single hospitals specialists are pushed into silos despite everyone acknowledging the need for ‘patient centred’ care, the physical estate is aging with very limited recourse for modernisation, patient expectations are going up but mentorship/guidance from senior teams going down - made worse by industrial action.
Policies and procedures isn’t what makes an organisation function, its the staff, cultural and behaviours. We need more than ever senior leaders who understand how to motivate, support, lead staff in some of the most challenging conditions the NHS has ever faced. However when you look at the pay the private sector offers senior leaders in similar positions, I’m amazed at the drive/resilience of CEOs in the NHS.
A single doctor who doesn’t do their job well will impact on a few patients at a time at the most, an ineffective CEO has huge ramifications for health care delivered to often millions of people and thousands of staff members. People can make up their own minds up about pay rates of senior leaders in NHS organisation…..Do a few WLIs and most Consultants can be earning more than the CEO.
Edited by gangzoom on Sunday 10th March 15:32
borcy said:
gangzoom said:
oddman said:
Up to a point it's desirable that staff are led by members of their own tribe. The obvious non clinicians are those in post in IT, HR, Finance and Estates.
And that's how you end up with IT systems clinicians hate, allocation of resources to projects that have little clinical impact or inadequate investments in things like theatres.Clinical led decision making is vital at every stage, in particular its mad to procure an IT system if the decision is made by people who don't know the difference between CRP and C-ANCA.
Edited by gangzoom on Saturday 9th March 16:46
My experience with Drs is they don't like the word no. Experts in their field but often have very little understanding of how other areas work and their needs.
Perhaps harsh, but probably more that they don't want to step into areas where they aren't the expert in the room.
98elise said:
I can't say I've ever been involved in an IT system implementation that didn't have lots of input from the users/stakeholders. Every part of the design process was signed of by the business. My last project before I retired was for the NHS (Non clinical though). It was no different. You cannot gather requirements, write functional specifications, draw up processes etc without imput from users and managers
This sums up what 99% of doctors feel about the state of current EPRs….Bare in mind for every other industry digital technology have literally revolutionised the way services/business is done. Personally I don’t think money or technology are the main barriers stopping digital transformation in the NHS….https://www.newyorker.com/magazine/2018/11/12/why-...
https://www.panorama-consulting.com/nhs-it-system-...
https://youtu.be/xB_tSFJsjsw?si=fJ-KyscuF6M5z7nA
Edited by gangzoom on Sunday 10th March 10:52
5 years+ in medical school, live in a world of tech, than get forced to use clinical EPRs......there is so much work to do in clinical digital transformation I recon my job is safe for many life times 
.
https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
.https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
Edited by gangzoom on Monday 11th March 07:17
meanwhile the board are staring at pretty chartsgangzoom said:
5 years+ in medical school, live in a world of tech, than get forced to use clinical EPRs......there is so much work to do in clinical digital transformation I recon my job is safe for many life times .
https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
.https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
Edited by gangzoom on Monday 11th March 07:17
gangzoom said:
5 years+ in medical school, live in a world of tech, than get forced to use clinical EPRs......there is so much work to do in clinical digital transformation I recon my job is safe for many life times .
https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
One of my consultant friends told me that no hospital has ever implemented EPIC without going bankrupt afterwards. No idea if that's true..https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
Edited by gangzoom on Monday 11th March 07:17
As a patient, I rather like EPIC. Addenbrookes has implemented a reporting app so I get immediately pinged with all my appointments, reports, results, etc.
AstonZagato said:
One of my consultant friends told me that no hospital has ever implemented EPIC without going bankrupt afterwards. No idea if that's true.
As a patient, I rather like EPIC. Addenbrookes has implemented a reporting app so I get immediately pinged with all my appointments, reports, results, etc.
The physical/local server setup required by EPIC is not information that's publicly available, but lets say its not as simple as ordering a few more laptops from PC world As a patient, I rather like EPIC. Addenbrookes has implemented a reporting app so I get immediately pinged with all my appointments, reports, results, etc.
. Published peer reviewed material is around, the narrative backs up the informal feedback. Now imagine trying to deploy that in the context of huge financial challenges, clinical pressures on waiting lists and the general mood of the workforce. https://www.sciencedirect.com/science/article/abs/...
Digital deployments is just one part of what our CEO has to manage, how you balance that with CQC findings, new national mandates, novel drug/treatments (which all cost extra ££££), pushing freedom to speak up, watching out for the next Letby......How many people here will do a NHS CEO role for the salaries posted a on here....
For patient facing app/information, 100% agree, however we have to get Consultants to stop writing stuff down on paper first, which is easier said than done
..................Oh but I do worry about widening inequity of care better patient engagement MAY bring. I say MAY because there are opportunities to reduce inequity with technology, but equity isn't the same as equality, its by definition impossible to do both at the same time - However that's a whole different debate, but the CEO cannot just debate, they have to act. Edited by gangzoom on Monday 11th March 13:21
gangzoom said:
5 years+ in medical school, live in a world of tech, than get forced to use clinical EPRs......there is so much work to do in clinical digital transformation I recon my job is safe for many life times .
https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
As a person who once used to write software for the MDT meetings - have a .https://youtu.be/MGsVjaS2NII?si=4RMz7dkumGaGpKK-
Edited by gangzoom on Monday 11th March 07:17
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