Public sector cost cutting is very much a theme of the moment. I suppose in my narrowly focussed view, I thought that we would be struggling but wouldn’t necessarily see any immediate changes – at least as far as front-line clinical work is concerned.
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I was too complacent. Already, changes are being felt and all agency staff have been given their notice to leave our team – which will leave us short of a few full time members of staff across the service and it really isn’t that big a team in the first place.
There’s a fairly bleak outlook in the office at the moment.
Not simply because those who are leaving are extremely competent, experienced, valued and just overall pleasant members of staff, but because the effect on service delivery and quality of care is going to have an immediate impact.
Already we are bursting at the seams in terms of workloads.
My frustration at the moment is that I feel I’m not able to work in the way that I would like to and it seems almost verging from crisis to crisis.
The true frustration though lies somewhat in not being heard from above. We are issued many many diktats about performance indicators and targets that we are slipping on and how we need to make sure we document and record various parts of the work that we do leaving less time for actual clinical work.
Last week, the Service Manager cornered me. He is a very pleasant, affable and jovial chap. Honestly (and perhaps surprisingly) I feel quite confident and supported generally in my management structure.
He asked me about some outstanding reviews that needed to be logged or it would ‘look bad’ on the system. As it turned out, most of them I had actually done but hadn’t logged properly so it wasn’t as infuriating a conversation as it might sound (and another I had genuinely scheduled for later that week!) – but I couldn’t resist a pop about understaffing and expectations that were increasingly being made on our time by administration and non-functioning snazzy computer systems that have been installed.
I am also possibly fairly rare in that I don’t mind the paper light systems we have moved to which mean that case notes are all logged online and documents uploaded instead of filed. For me, the less pieces of paper floating around randomly that can potentially be lost, the better – but sheer frustration has resulted when the wonderful systems fail to actually work – as will happen with any technologically based system.
So at the moment, the office seems to be caught on a bit of a downer – to say the least. Hopefully, well, it’s hard to know where the hope is to come from. The work is not going to decrease as staffing decreases. Perhaps we will all find more efficient ways of working – or at least, that’s the ‘management speak’.
A few years ago, in a different team and different department, I had an Assistant Director follow me round for a half day to ‘see the work that we did ‘on the ground’’. I quite enjoyed it because it gave me a good opportunity to expound my thoughts on the service and although one of the visits was straightforward, the other was a matter of a user asking for resources that just did not exist within our service. We had a frank and full discussion about commissioning, resources and the choices that we have to make and explain on a daily basis. It was almost cathartic!
I do wonder sometimes how detached some of the higher tier managers have become though. I know cuts have to be made but it is so tempting to suggest that some of the ‘project managers’ be shaved off the services as opposed to front line clinicians and vital admin support.