Geraldine Scott of the Eastern Daily Press reports:
New data has revealed the number of doctors at the region’s mental health trust has shrunk over the last five years – whilst the number of managers has risen.
Figures from the Health and Social Care Information Centre (HSCIC) showed in July 2017 there were 20.3pc fewer doctors at Norfolk and Suffolk NHS Foundation Trust (NSFT) than in July 2012. But there were 52.7pc more managers.
These figures are shocking. We’ve been warning about the toxic managerial culture at NSFT since 2013.
But NSFT chief executive Julie Cave disputed the data.
The data is derived from the NSFT’s own NHS payroll data collated by NHS Digital and was the very latest available. NSFT directors have a habit of denying their own data.
HSCIC [NHS Digital] data shows over the five year period the number of consultants dropped by 16.7pc, specialty and associate specialist numbers fell by 36.3pc, and the total number of junior doctors was 13.5pc down.
The figures showed 20.7pc fewer qualified nurses, midwives or health visitors. Meanwhile, the number of managers jumped from 82 in 2012, to 125 in 2017.
We are investigating what has happened to senior management pay as the pay of front line staff has been frozen or capped at one per cent. We already know what has happened to the pay of the chief executive and directors as mental health services were cut and rated inadequate. The former NSFT Chief Executive, Michael Scott, Director of Nursing, Quality and Patient Safety, Jane Sayer and Leigh Howlett, Director of Strategy and Resources, are still being paid by NSFT even after ‘retiring’ or ‘resigning’ in the aftermath of the CQC’s damning verdict on the quality of NSFT’s management. According to NSFT’s interim Chief Executive, Julie Cave, it is ‘routine’ to pay the NHS executives who fail six-figure salaries for six months after they stop working.
However, Mrs Cave said NSFT data showed between March 2013 and March 2017, a 2.13pc decrease in doctors, a 15pc drop in nurses and a 23.5pc drop in managers. She also said the number of unregistered clinical support staff has increased by 6pc.
What do we trust, NSFT’s ‘reviewed’ data or the NHS payroll information held by NHS Digital?
Whatever Julie Cave claims, a fifteen per cent drop in the number of nurses over four years is extremely significant.
Mrs Cave said: “The classifications of NHS staffing have changed over time so trying to draw direct comparisons over lengthy periods from raw data does not necessarily reflect a true picture. The data on the website is covered with the following caveat: ‘It has a provisional status as the data may change slightly over time where trusts make updates to their live operational systems’. We had a number of senior clinical leadership roles classified as managers. We have reviewed our data to ensure consistency with the latest national definitions.”
She added the figures would not include bank or agency workers, or doctors on mental health placements from other trusts.
The national data should work in NSFT’s favour: the big change during the period has been to latterly include NHS Professionals in the numbers of doctors and nurses employed, which should have benefited NSFT as it employs large numbers of bank staff. And the ending of the Section 75 Agreement with Norfolk County Council should have had little effect on the numbers of doctors and nurses but should have led to fewer managers. But we know that many of NSFT’s managers engineered themselves new management positions to avoid going back to Norfolk County Council, where they might have been expected to do some work. What does ‘We have reviewed our data’ mean? We think we know and it isn’t pretty.
We’ll publish what has happened to the number of doctors and nurses employed by NSFT over the last few years to set the record straight.
However, a spokesman for the Campaign to Save Mental Health Services in Norfolk and Suffolk, said: “Since 2013, we have repeatedly warned about the increasing number of managers employed at NSFT as mental health services have been savagely cut. But the NHS payroll information is worse than we could have imagined. The NHS managers responsible for mental health services seem to believe that doctors, nurses and patients are inconvenient costs and that the solution to a problem is always another manager or to cut front line staffing and services.”
It comes as nationally, the Health Foundation found although the overall NHS workforce increased by 2pc in the year to April 2017, managers had the highest rate of growth with a 4.3pc rise.
Across the country there was a continued growth in hospital-based doctors but the number of GPs and nurses plummeted. At other NHS trusts in our region:
• At James Paget University Hospital, in Gorleston, there were 2pc more doctors, 11pc fewer nurses, and 7pc fewer managers.
• At the Norfolk and Norwich University Hospital, there were 6pc more doctors, 12pc fewer nurses, and 9pc fewer managers.
• At the Queen Elizabeth Hospital, in King’s Lynn, there were 5pc fewer doctors, 10pc fewer nurses, and 11pc fewer managers.
• At Norfolk Community Health and Care there were 3pc more doctors, 12pc fewer nurses, and 7pc fewer managers.
So, the other NHS trusts in Norfolk reduced nurses by about half as much as NSFT, three out of four employed more doctors while NSFT cuts them and all reduced the number of managers while NSFT increased them by over fifty per cent.
But Mrs Cave said the roles needed in mental health were different. She said: “Mental health and physical health trusts cannot be compared like-for-like.
We didn’t compare them like-for-like. We compared the change in the number of doctors, nurses and managers employed in each trust. More spin.
“NHS Coding does not always fit mental health job roles. In mental health the key clinical roles are not necessarily nurses or doctors roles. A large number of staff are psychologists and psychotherapists, social workers, for example, who may be neither a nurse nor a doctor.
Again, this hasn’t changed over the period and the numbers of these staff is not broken down as is the case for doctors, nurses and managers so we didn’t compare them. But we know that NSFT has less of these staff too than they did. Many psychologists, psychotherapists, occupational therapists lost their jobs during the radical redesign and many social workers returned to Norfolk County Council when the Section 75 Agreement ended. More spin.
“Traditional nursing functions are increasingly successfully undertaken now by an expanding range of other professional and qualified staff. This frees up the nurses and doctors for work which specifically requires their skills.”
And increasingly by unqualified staff. More spin.
She pointed to roles such as allied health professionals, who Mrs Cave said are “vital in providing appropriate care to our service users”.
We never said they weren’t. This is quite simply an accountant’s clumsy attempt to divide and rule front line professional groups at NSFT. Disgraceful spin.
However, a spokesman for the Campaign to Save Mental Health Services in Norfolk and Suffolk said: “Across the other NHS trusts in Norfolk, the number of doctors has risen by 2.9pc while the number of managers has fallen by 9.3pc. NSFT now has 67pc more managers than the Norfolk and Norwich, a university teaching hospital with three times the turnover, nearly twice as many qualified nurses and more than five times as many doctors. While NSFT has 30 senior managers, the N&N has 12. NSFT employs 1.3 doctors for every manager, while the N&N employs 12.25 doctors for every manager. This pattern is repeated across Norfolk, with NSFT having more managers than the James Paget and Queen Elizabeth hospitals combined.”
Click on the image below to read the story in full on the EDP website: