Thinking about…

One of the most important relationships in my life after my family relationships have been with my administrators and back office teams.

Without the support (and attention to my idiosyncrasies) that each of the people who supported me throughout my career gave me, I can honestly say that I would never have achieved as much as I did. This makes me wonder how the UK government can think that, demanding NHS organisations cut their back office teams by 50%, will improve public services or lead to greater efficiency. After all do we really want our doctors, our nurses, our allied health professionals, our social workers and everyone else involved in directly delivering care, support and treatment, wasting a lot of their time filling in forms, organising appointments and sitting behind desks staring at computer screens? Wouldn’t we rather they spend more time with people who are unwell? It really does feel like daft policy making, without properly looking at the evidence in action.

If we look at the research around how administrative support empowers people in healthcare to be able to focus on caring, supporting and treating people, the evidence suggests that effective support by administrators makes a big difference to a professional’s productivity.

Arnezt et al (2020) published an exploratory study that looked at how to enhance healthcare efficiency. They looked at how delegating administrative tasks effectively could support reducing costs, improving population health, patient experience, team wellbeing and productivity. Whilst it was only a small scale study it demonstrated that when administrative tasks are delegated appropriately, the number of available slots for patient visits went up by 48%, health screenings went up, healthcare workers wellbeing went up, and patients felt more positive about their experience.

A Kings Fund report (2021) suggested that good quality administrative support can potentially improve patient experience, promote better care and improve the working environment. Improving administration can also help to promote inclusion and help to address inequalities.

Reading these studies has highlighted to me that supportive administrative structures and the delegation of administrative tasks can lead to more efficient healthcare delivery and improve outcomes for patients. 

Administrators are the oil that keeps the engine of our public services working. They are the fundamental link between people with lived experience, their families and the professionals that enable good quality care, support and treatment. These hidden roles  might be poorly paid, unglamorous and often go unnoticed, but without their essential contribution (or with a 50% reduction in them) it’s likely that the productivity of our health service will go down rather than up.

If anything we need more administrators so that our doctors, nurses, allied health professionals and social care workers can do the job they should be doing, helping people get well and enabling people to do the work they were trained to do.

Honestly, how would minsters ever get anything done if they reduced their administrative and back office staff by 50%? My guess is that they would struggle and be much less productive at everything they are trying to do. Perhaps they should give it a try first themselves, before imposing an arbitrary cut to administrative workers and back office staff across the NHS.

So, Donna, Julie, Karen, Yiota, Doris, Jane, Sally, Victoria, Oliver, Serena, Lorraine, Shelia, Karen, Manjet, Helen, Lauren, Kate, Lori, Claire, Carl – thank you.  With out you and everyone else in the back office teams I worked with, I would have been at least 50% less productive.

References

Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study (2020) Arnetz, Goetz, Arnetz, Sudan, VanSchagen, Piersma, Reyelts.

A Kings Fund report, Admin Matters: the impact of NHS administration on patient care (2021) Ewbank, Lamming, Cream, Wenzel.