Former NHS Nurse and manager now contemplating the NHS from outside

Archive for the ‘Work’ Category

Back

After 3 months of rest, recuperation, holidays, spending money and general enjoyment I am now back working for the NHS. Note the word ‘for’, since I am not actually part of it. I am now an independent contractor working on a project that was left unfinished. I am back with my ex boss and her small team. I am back in the same office, in the same building I left at the end of March. I have re-instated my nhs.net account and hopefully in the next few days I will be able to log onto work computers again. Yesterday I went into the office; it was to say the least surreal.

I used to look at the invoices of contractors and discuss with colleagues that they seemed to earn a lot of money for what they did. I am not sure that the rate I have negotiated is excessive, since I will have to pay my own tax and national insurance, but it is a reasonable amount. I am going to be working 3 days a week for the next few months and hopefully that will put me on a footing for more work in the future.

The building now contains several organisations, where in March there was one. I heard that the staff working in the CCGs are not always pleasant and friendly to those working for the CSU. I heard that already people are leaving, jobs are becoming vacant. I heard that a number of those who were made redundant, are like me, back working. I heard that those working in the CCGs are still trying to work out what exactly they are doing. I guess that is no surprise.

I found yesterday in the office a little claustrophobic. It is 3 months since I sat still for so long, since I sat in such a small office for so long. I think that 3 days will definitely be enough in one place. Mind you I will be out and about a lot, my job is to try to sort out the clinical groups so that they are fit for purpose in the future. I am going to finish off the job we couldn’t do last year and which predictably there currently are insufficient permanent staff to manage.

Still it is nice to be back in the world of work even if I will now have to juggle it around my expanding social life. But, I do still have some bills to pay even if I am now completely debt free!

Process

The process which led to my redundancy and now it seems, beyond progressed neither smoothly nor as it should. I haven’t written about this before because I believed that I had put it all behind me. Yesterday I discovered that this is not the case.

A few weeks before my redundancy I received one of many letters from HR, this time offering not just redundancy, but a choice of that or taking one of two pension packages. I was surprised, despite still being in the 1995 pension scheme, and having paid in for over 30 years, I was (and still am) only 50. I sought financial advice and decided to take the maximum pension lump sum, a monthly pension and a small redundancy payment. I duly completed the forms and sent them in to payroll. Yesterday, more than 4 weeks later, I contacted NHS pensions to discover that my employers did not submit the online application to them until 2nd April and secondly that it takes up to 3 months to process a claim. Employers are meant to ensure that employees apply with 3 months notice.

Of course my employer would have preferred not to make me redundant, therefore they were late to give me any notice at all, and until about a week before they acted as if a magic job might appear on the horizon for me and my colleagues. Therefore everything was completed at the last minute, or in my case beyond that date.

Thankfully I have some money to ensure that we don’t starve before July, NHS pensions say that any payments will be backdated, but really that is not the point. This is really just about the way I have been treated from the moment it became apparent in around November that this wouldn’t be a smooth process. Consultation processes were not completed as they should have been, interview processes seemed at the best odd and then there was the whole ‘at risk’ situation and the feeling that you could be shoved into any job. One day, someone approached me and offered me a job in IT on a lower salary and for fewer hours than I was at the time contracted to work. Suitable alternative employment it was not.

I was not obstructive, I did as I needed to do and applied for no end of jobs. Jobs that I could see myself doing. I had been in this kind of position before and wanted to come out of it with my career and reputation in tact. That slightly went wrong and I am required to be compensated for that. I am annoyed that yet again the process has let me down! I am also annoyed that I can’t get my kitchen refitted yet, and that by the time I do I fully expect to be back in work (more about that when things are confirmed).

End of rant!

Seeking closure and embracing new opportunities

It is only two days since I ceased to be employed in the NHS and I know that it will take a little longer for my mind to defog and my brain to clear. The main thing for me right now is the amazing tiredness I feel. On one hand I want to do so much with my free time, I want to sort out the spare room and make it in to some kind of office space – I have brought home a load of personal and also kind of work related stuff that I think will be useful in the future. I also want to have a bit of a spring clean around the house, I want to declutter and I also want to do some fun things. I want to organise trips away. I am also mindful that I will need to work at some point soon, so I have some work to do in following up contacts and preparing for work.

Usually, I find myself rushing around, doing a bit of this and a bit of that. Rushing to complete things over the weekend or during a few days off. I am aware that this is different. I no longer need to rush anywhere, to complete everything in double quick time. I am also aware that I do feel weary as I said above.

I need to spend some time right now reflecting on what has happened, thinking about the process that I was involved in. A process that started with me feeling incredibly hopeful that I would get a job and a good one at that and ended with me being made redundant. I hope to use this blog to help in that process. I have been a poor blogger for a couple of years now. Firstly it was because I was unhappy in my commissioning job, then too busy in my new cancer network job and then because I feared saying something which could ultimately get me into trouble with my employers.

This morning, there is lots on the news programmes about the various changes that have come into force in both the NHS, in welfare and in local government. I feel I should be able to say some profound things about all of this, today, indeed right now. But actually I don’t think I can.

I am going to take a few days. I am going to read a book or two. I am going to get back to reading  some of the blogs around and about, and update my blogroll here. I am going to start sorting out the spare room and I am going to look around the shops. After all a girl is entitled to retail therapy when she has been made redundant!

Then in a few days, as my brain and my mind begins to clear I will write about the past and about the future. I will talk generally about my take on how things are in the NHS and also about my role in it (if I am to have one). I am not meant to work for the NHS for a month. I don’t think that will be a problem for me.

My first day has started a bit strangely. I was happily blogging, sitting up in bed when the phone rang. My son who went off to visit and stay with friends yesterday called to say he was on the train and could I pick him up shortly. I found myself scraping the ice off my car at 7.30am; not the way I expected to start my first day of freedom!

Business as usual

In the middle of a chaotic reorganisation we carry on regardless. We are busy supporting our network groups, arranging workshops and training, recruiting users to help with service developments and reporting on things that have been done. We are busy full stop. We work hard and we work pretty long hours between us. But, you might ask and I often ask, why? Why are we bothering to put so much effort into things that we don’t know will continue in the future?

Well partly because we are kind of required to do so. There are rules in place, there are requirements on us and they haven’t gone away. There are also people out there, clinical people, who still need our support to be able to meet together and discuss how they can continue to improve things for people with cancer. There are campaigns for early diagnosis that we are still involved with and detecting cancer and doing so as soon as possible is a priority area. We are also trying to create some kind of legacy, to make sure that what we do, what has been done continues. While people in high places continue to work out how the new world will work, we carry on working in this world.

We are interacting now with the new CCGs; the board members, GPs who are finding out about their responsibilities to their populations. They find that we do useful work, have knowledge they can’t hope (or want) to learn. They wonder how, come April they will be supported in making sure that cancer and end of life care is best commissioned.

We prepare to apply for jobs. The adverts were meant to have been released last week, now apparently it will be this. The top job will be appointed to in the next week or two and then that person (and who knows who else) will interview us sometime in the run up to Christmas. In the new year we will know more about what those with jobs will do in them and we will discover if we continue with business as usual in the old set up.

It all feels a little unreal. But of course it is real. These are real people, with real jobs, real mortgages and bills who shop in real supermarkets and go on real holidays. It is easy to write off those who work in some kind of administration. But the fact I left clinical practice enables others still seeing patients to spend as much time as possible doing so. If there are fewer of us doing those supportive jobs, either fewer patients will be seen or else fewer patients will be able to be sure that advances in implementing best practice will take place.

Those of us who get jobs in the new world of strategic networks will work hard to make sure this doesn’t happen of course. But there are no guarantees. Of course I may be wide of the mark and the new systems may be an improvement on the old ones. Lets hope so for all of our sakes!

Time for an update

Was it really March when I last posted here? For a long time this year, very little happened in my bit of the NHS. Essentially we got on with the day job and waited. I had got fed up with writing about it here and if I am bored, I can guarantee that it wouldn’t make very interesting reading. I think that situation has changed and that what is currently happening in PCTs (and elsewhere) to be honest needs to be written about, since there is little being said in the media or newspapers (other than the Guardian). I predict that once the dust has settled and the ‘bureaucracy’ has been removed, some people will be very shocked by what is left. They will be surprised that the NHS isn’t actually being run by GPs (though they have a wonderful nominal role) but by rehashed senior managers some of whom work in Leeds and many more work out in the local areas.

Over the next few days and weeks I will try to explain the mess that Andrew Lansley put in place and what the implications are for people like me. More importantly though what are the implications for people working on the front line, and vitally what does it mean for patients? Will any of this matter? Time will tell I guess but I suspect that perhaps it will.

The Cancer Networks, one of which I work within, will be subsumed into a new kind of Strategic Clinical Network. This will include not just cancer, but heart disease and stroke, mental health and maternity and children. There will be 12 of these networks which will be hosted within some of the Local Area Teams of the National Commissioning Board. Staffing will be reduced from current levels, but with just a few months to go, we don’t really know by how many nor indeed to we know exactly what these people might do.

My job is about facilitating clinical people to work together to improve cancer outcomes. Some clinical people, I might tell you, need a hell of a lot of ‘facilitating’. I also work with patients and carers to make sure that they are able to contribute to the development and delivery of services. When (rather than if) that kind of support is not available, I am not quite sure what will happen. The work of course will go on and best not to engage in some kind of amateur dramatics here about the value of me and my colleagues. But there are lots of things that we do, that appear to be valued and necessary that I can’t imagine being picked up by any one else. So as things emerge, I will try to discuss them here.

We really are on count down now, and likely by the end of the year many of us will be on notice of redundancy. Others though are luckier, particularly those working in areas where they can be mapped into jobs in the CCGs, the CSU or Public Health. I hear you cry what is a CCG? What is a CSU. Well good question and perhaps I could do a little bit along the lines of trying to define them. Maybe you can tell I am just a little bit more keen to return soon and say more. Time to resurrect this dying blog and wonder about what Life in the NHS is like right now!

Spring has sprung

I love this time of year. Each day as I look out of the window, drive to work and back I notice that the leaves have a little more blossom, a few more leaves. The daffodils are now in full flower and to top it all we have been experiencing highly unusual sunny and warm weather. It makes you feel good. Spring is a time of new beginnings a time to clear out the cobwebs, to clean the house, to get ready for the summer ahead. This year I approach spring feeling refreshed because I have recently had 3 weeks off work; 2 in USA and 1 at home. I have taken a break from work, and from concerning myself with the problems of the NHS. Now though I am back in the mix and raring to go.

The Government must also be glad that with the advent of spring, they have finally got their Health and Social Care Bill through; it will receive royal assent within the next couple of weeks. Mind you I believe they have other worries (a budget that many felt favoured the ‘haves’ rather than the ‘have nots’, scandal over dinners with David Cameron and an impending fuel tanker strike to name a few).

Next week we start a new financial year, the last of the PCTs. This is going to be an interesting year as we head towards transition towards the new world of healthcare commissioning and provision. Already our PCT is getting ready to become a Commissioning Support Unit. Local Clinical Commissioning Groups are preparing to be ratified or whatever the process is called and everyone without exception working in the health economy faces the reality of doing more for less money (that’s just the budget but personally we face similar challenges).

I don’t agree with the Bill but enough is enough. We have to move forward, we have to prepare for new beginnings. I fear things won’t go completely as the Government would like and in a perverse way I am quite looking forward to seeing how it all pans out. It would be fun if this wasn’t public money, real lives and real jobs. What is worse is that this is healthcare; mistakes can lead to people missing out on the care they need and it can lead to death. We watch and wait.

Meanwhile I’ll enjoy the good weather while it lasts; it will turn cold by the weekend and eventually it will rain!

A slow death

So the progress of the NHS Health and Social Care Bill goes on and on. This week the Bill has gone back to the house of Lords, where the hundred or more amendments will be debated and either rejected or passed. Everyone who understands anything about this Bill and it’s implications knows that it is doomed to failure. We know that rather than less bureaucracy, more will be created, that where private industry is brought in to run services they will soon realise that healthcare doesn’t tend to run at a profit, unless you are a GP lining your pockets. The people to suffer for this mess will be the people in England with the greatest need; people with little or no income, who lead what might be described as unhealthy lives, who can’t articulate what they need and often who suffer from more than one long-term condition.

Those of us who work for PCTs will now have to go through a final, slow and painful journey to whatever awaits us; NHS commissioning board outpost, Commissioning Support Unit, Clinical Commissioning Group, Local Authority. Fewer people doing the same or more work. Contrary to what the government say it will be the same people doing the work next year, only there will be less of us and we will be spread around a number of organisations. The outlook feels gloomy.

Short term though I finish work tomorrow for 3 glorious weeks away from the PCT.  2 weeks visiting my lovely son in California for his 21st birthday and another resting  up at home. Hopefully I will return refreshed and ready to face the final year of the PCT; I think I am going to need it!

Of course we can only hope that while I am in the USA something untoward happens!

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