Thread by @drokane

NHS management 101
If u are not complaining then u are overstaffed. You will lose assets
If you are complaining then you are at peak efficiency and assets sweated
If u r complaining + metrics worsening + adverse event. you might need help but first will be told to get a move on

contd:
If there are patients in corridors during surge then you have enough beds. Ride it out
If there are never patients in corridors during surge then you have too many beds
If there are patients in corridors frequently then sweat your discharge process. Might need more beds.

The weakness is that over staffed departments with staff learned in the art of complaining don't get touched as too much work to analyse the metrics and redeploy assets. Managers only around for 1-2 years so pass the parcel.

Non complaining burnt out staff in an overworked department who are sinking will be ignored as long as they are doing the job but at some point will implode.

The earlier that you understand this the better

PS I am all for sweating assets and reducing overall tax burden. The NHS is incredible value for money. There is little to no fat to trim. Main issue is medical vs social care budgets in different pots controlled by different people each with no incentive to share.

If social care take patients earlier who are medically fit then they will want some NHS money.

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