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National Voices Report on NHS Admin

A research collaboration between National Voices, King’s Fund and Healthwatch England looked at NHS Admin.

“From the moment a person first engages with any part of the NHS to when they see a clinician, receive follow-up communication, and well beyond this point, administration is a critical thread that affects the chance of a positive experience and therefore, a positive health outcome. Yet, little research has been done on administration. “

National Voices’ publication, Paper Works: the critical role of administration in quality care, documents the central role administration plays in people’s healthcare experiences and argues that administration is pivotal, not peripheral, to quality care.  

The King’s Fund long read, Admin matters: the impact of NHS administration on patient care, suggests a framework for improving the quality of admin based on insight from patients, carers and NHS staff, and here Healthwatch England argue that a focus on NHS admin is needed to improve people’s experiences of healthcare.  

You might also like to watch and share this illustrative video, which shows the power of a smooth administrative process, and the harm of a confusing or inaccessible one – which stretches far beyond inconvenience to actually exacerbating ill health, and even embedding health inequalities.   

My view

This subject is something that I feel passionately about, and indeed often has effects on my mental health.

I qualified as a medical secretary back in the 1980s, a two year full time Diploma Course. We studied Medical Science and Terminology, the structure and working of the NHS, Medical Secretarial duties (in hospitals and GP surgeries) and English Language to a standard way above GCSE, as well as Medical Audio-Typewriting and Medical Shorthand. The English component involved a ‘project’ of some sort, a role-playing situation on the telephone (for instance having to get a patient to come in to see a doctor urgently instead of going on holiday without telling them why!) as well as the written exam. We had to do two placements, one in a hospital and one in a GP surgery and also had to pass a First Aid course. We observed in an operating theatre and visited a Pfizer pharmaceuticals factory during the course.

As well as working as a medical secretary in various hospitals, I was the Office Manager of a Private Menopause Clinic run by a charity and the Administrator of the Centre of Medical Law and Ethics at King’s College London.

I am frequently horrified and actually angry at just how low the standard of admin is now. It is my belief that in an effort to save money, treatment of patients has declined and actually money is being LOST because of the chaotic admin. I don’t blame the individuals involved, they are not trained, badly paid, and there aren’t enough of them. Only last week I finally got hold of a letter sent by a hospital which had not been stamped and I had to sort out the fee of £2 online in order for it to be delivered. I wonder how many people are marked down as DNAs because of this sort of mistake? A letter received at the weekend reads “The patient reports frequent ear surgery when constantly wearing hearing aids.” – I have no idea what the word typed as ‘surgery’ should be!! Sometimes, because I have so many medical conditions, sorting out my own admin is almost a full-time job – correcting mistakes, chasing up missing communications and so forth. This really does affect my mood and emotions quite seriously.

RANT OVER! I am glad this issue is being addressed by someone though!

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