NHS administration ~ In my experience

So often our National Health Service is wonderful. When I was admitted last year, as an emergency case l couldn’t fault the excellent service and treatment I received from everyone involved. Within minutes Of arriving in A&E I was in a bed, surrounded by doctors and having blood taken as they suspected a variety of things from meningitis to a heart attack to pneumonia caused by a blood clot on my lung. It turned out to be the latter. I was well looked after in hospital and have no complaints whatever about the entire experience,  but when it comes to admin in the NHS, there have been too many incidents that have caused me to shake my head in frustrated disbelief.

On one occasion I was waiting for a hospital appointment and informed them that there was just one day that I definitely could not attend as it was my son’s wedding. The appointment came for that day. When I rang to change it I was asked what time the wedding was! Did they seriously think I was going to attend on the same day as my son was getting married?  I had my diary with me and was ready to agree an alternative date but this couldn’t be done; they would send another appointment by letter. Who makes these crazy rules? What on earth does it cost to type the letter and post it to everyone who needs to change an appointment.

A while ago I arrived for a routine hospital appointment. I was asked to confirm my name and date of birth. The receptionist then stated my address by way of further confirmation. Except that it was  an address that I left in 1979.  Why was it still even in my file? I’ve lived at five other addresses since then.

Some months after that I received a letter from the same hospital. Despite it being sent to the correct address, it contained a copy of the letter they had sent to my GP which detailed my name and an address that I left in 1995.

I have worked in Human Resources for four employers. In each of those the ratio of HR staff to employees was in the region of 1:130. Back in 2013 I took on a three month interim position in the NHS in order to implement a new procedure. The site had 800 employees and 13 staff in the HR department – a ratio of 1:61.  My work was finished by before lunchtime each day. When I asked for something else to do, I was told that this wasn’t possible as it would mean taking work from someone else. When I ventured to say that the department seemed a little overstaffed (gross understatement), I’m sure that the horrified gasps of my colleagues could have been heard throughout the hospital.  The NHS is often criticised for having too many layers of management. This was clearly the case here: there was a Head of HR and organisational Development, HR Manager, HR Advisor, HR Officer, HR Assistant and several HR administrators.  Only in the very largest organisations is this the norm. In most companies of 800 staff there would be no more than three grades. I don’t pretend to know whether this is replicated across the NHS but it was hugely disappointing to witness such financial inefficiency due to over staffing.

What has prompted me to write about the NHS today is something that happened earlier this week to a close relative. He has to attend hospital several times a year for a drug transfusion. As per usual instructions he rang the hospital early on the day of his 12 o’clock appointment to check that the medication, which is specially ordered in, had arrived. He was informed that his appointment was at 10am, not 12 o’clock as shown on his letter, so he left home immediately to make the 50 minute journey. When he arrived they could find no trace of his appointment and denied that it had been made! His letter showed otherwise but he was informed that it must have been a mistake. However, they advised that he should have been there at 8am for a different procedure. He had been expecting an appointment for this procedure but had received no letter. The upshot is that he now has to wait again for both appointments.  Unsurprisingly  their systems did not allow him to book them there and then.

I am aware that my comments could provoke some strong reactions from anyone working in the oft-maligned NHS and I know that administrators don’t have the power to effect change in the way that things are done, but as admin procedures go, what an abysmally inefficient system.




  1. For your own sakes, I sincerely hope you are NOT moving to a private system. This is coming from a person in the United States, where healthcare is a privilege, and not a right, and a large medical bill will bankrupt you. I envy people who don’t have to make life decisions based on where their healthcare is coming from and how much it costs.


  2. I have nothing but praise for the medical staff who have saved my life on two occasions, once with my treatment for breast cancer and then for emergency surgery to remove my gangrenous gall bladder. Each and every one of them was kind and professional, regardless of their workload.
    However, administration needs to be looked at. Recently I was in the physio dept of what was our local hospital (no longer a hospital, but which goes under the ridiculous title of Health and Well-Being Centre) and I asked if I could make an appointment – I could see the actual physio dept, just feet away, but no, I had to go home and phone the booking office. All more work for me and, more importantly, for the system to cope with. You cannot credit the time wasting that must be involved if such things happen in every hospital throughout the country, can you? And as we know, time wasted is money wasted on phone calls and staff time.
    Margaret P


    • It is utterly ridiculous, Margaret. So frustrating. If I devised such inefficient processes, I wouldn’t have a job!


  3. a lot of government services were quietly privatised in New Zealand, Eloise, by our previous government, and many more services, such as mental health, were almost demolished. It has caused much suffering. Even the prison system. (omg!). Luckily we still have good equivalent of NHS, and long may it stay that way.


    • You really do wonder how the peop,e who make some of these decisions and devise the processes get the positions. It is all so frustrating


  4. I agree with your comments. I worked in the NHS for 30 years as a medical secretary. There’s a huge amount of money wasted in the NHS, through bureaucracy. I once asked my line manager if she could purchase me a small fold up trolley (several were already in use) in order to carry multiple heavy notes, etc. I’d seen one on the high street for around £12. She could in fact only buy one from a company she was contracted to buy equipment from – for nearly £40. We were all given new fans in 2014 – not a standard perfectly adequate fan – but a huge very expensive Dyson model ( my particular hospital was mentioned in a national newspaper for this inefficiency). Then at the other end of the scale we were audited on how many envelopes we used!! I could go on, but I’d be writing for ever more!! I got out at age 50.


    • Such a crazy system. Very many years ago I was in the Civil Service. At the end of the financial year we had to have used up all our office allowance or we would get less the following year. We all got new stretchy covers for our chairs and a dishwasher which remained unused because no one ever wanted to empty it!


  5. Sigh – don’t start me on the NHS! I was a general nurse from 1965-69 then a psychiatric nurse from 69-73. That’s a very long time ago. And, of course, over the years there have been enormous changes, not the least with nursing. Nursing has gone from an apprenticeship style of learning to an academic university degree kind of learning. A huge change and not for the better, just different. As for the admin errors your relative came up against. They’re bad and I hope a complaint was made as it will be the only way to get errors and mistakes recognised. But the NHS is under such pressure. For me the pressure is political as I sincerely believe the underfunding is deliberate. Furthermore, the move towards privatisation seems entrenched – actually it’s enshrined in law. We should look to France for a good tax-based health system which the population can top up, if they wish, and veer sharply away from ‘competition’, ‘contracts’ and an American-style version of health care. Could say much, much more!!!!!!


    • Oh I could go on endlessly about the contracts. PFI agreements were an abysmal decision. I’m also appalled that nurses now have to have a degree. My mother was a ward sister, and later a practice nurse. She maintained that a good SEN was worth their weight in gold and the move to degree nursing was an awful step. At a stroke, caring, practical but non-academic people were prevented from doing exactly what was needed. Yes, I think we are slowly moving towards a private system.

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