Tipped over the edge by NHS procurement and audit

Time is flying at a ridiculous pace. I cannot believe October is nearly here. Its a little depressing as well…

This week has not been good. I’ve had a really stressful and difficult week at work that started with me falling out with someone who did not provide support when requested, instead criticised me for a decision taken by my employer. Over a number of years our staffing levels have been reduced as cost improvement targets were deemed more important than the delivery of services to patients.  This week things have started to go wrong. Despite our best efforts we are unable to provide a suitable standard of service. This appears to be my fault for failing to create a contingency plan. In December I had highlighted to senior management that there was no capacity for a contingency and nothing was done. There is a consistent expectation that we will do more with less. I do believe that there is wastage in the NHS and areas can be improved but last year our service went through a long period of change implementing a number of measures to improve our productivity. I believe we have achieved as much as we can on our own. We have ensured service continuity on half the amount of staff we had 5 years ago (in fact we see 30% more people) but the service has absolutely no flexibility to cope with sickness.

The middle of the week saw an incredibly frustrating time over ordering a cable for a computer that left me mentally writing emails to the Secretary of State for Health.  After waiting 6 weeks for a cable from IT I contacted them. It appears they did not understand what I was requesting. The cable in question is available on ebay for £1.30. IT told me that postage alone would cost £10 and looking for the cable myself through NHS Supply Chain showed that the cable would cost £12.45. How on earth can a business the size of the NHS accept £22.45 for a cable that is available on ebay for £1.30?  We have no petty cash and I cannot reclaim costs so again, I bought the cable myself online. I wonder how much is the NHS propped up by well-meaning employees who would rather spend their own money than waste an exhausting amount of time and money going through the official ordering channels.

By Friday I had completely had enough and I sat and debated looking for a new job. This is the first time that I have very seriously had this thought.  At present I believe that I am a nurse first and a manager second. This week has felt the furthest from nursing that I have ever been and instead I have had to battle audits, risk assessments, sickness cover, procurement, finance and IT. All elements of my job that need attention but the demands on my time have been particularly hard.  The NHS cull of middle management was meant to protect patient facing services. My time and workload is proof that this isn’t true and I am now expected to do the work of the two managers above me who were made redundant and still carry on with my clinical caseload. When I’m constantly being told that audits and risk assessments are essential (I agree they are important) it is my clinical work that gets left behind. There seems to also be a trend in sending emails demanding a response ‘by close of play today’ – a phrase that I would happily see banned.

My service is about to enter into a difficult period of time as we’re in talks with our commissioners to create a specification for the next financial year. My thoughts at the moment are to see the service through that process and then evaluate and plan my next move. Is it time to look for the next step or further afield?



One thought on “Tipped over the edge by NHS procurement and audit”

  1. This makes me soooo cross! I have had my life saved by the NHS, and totally appreciate the work all the staff do, but like the education system the priorities clearly seem to have been royally screwed up by the powers that be


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