NHS Pay Plan has failed

July 30, 2007 12:21 PM

The Telegraph reports that the 'Agenda for Change' reform of NHS pay has failed to deliver improved productivity, according to the King's Fund health research organisation.  The cost of the change was under-estimated by £200 million and may have made up nearly half of last year's NHS deficits.


This is a colossal management failure.  According to the report the problems are caused by "a combination of rushed implementation, a serious underestimate of the costs involved, and a failure to embed personal development plans for all staff has made it difficult for the new system to bring about real improvements in care."


That could give the impression that this failure is an isolated case.  It isn't.  Failures in an NHS ranked close to bottom among developed country healthcare systems by the EU and BMJ are a result of politicians without management experience of subject knowledge running a department with over a million staff, one of the largest organisations in the world.


This overcentralisation would seem to be made worse by the Agenda for Change which introduces national pay scales within the NHS, further centralising pay decisions.  This means that when politicians make mistakes, as they clearly did in the GP contract that has increased pay and decreased the amount of work done, their failure is exponentially more important.  Increasing the scale of the decision also increases its complexity which increases the chances of a mistake.

The Telegraph reports that the 'Agenda for Change' reform of NHS pay has failed to deliver improved productivity, according to the King's Fund health research organisation.  The cost of the change was under-estimated by £200 million and may have made up nearly half of last year's NHS deficits.


This is a colossal management failure.  According to the report the problems are caused by "a combination of rushed implementation, a serious underestimate of the costs involved, and a failure to embed personal development plans for all staff has made it difficult for the new system to bring about real improvements in care."


That could give the impression that this failure is an isolated case.  It isn't.  Failures in an NHS ranked close to bottom among developed country healthcare systems by the EU and BMJ are a result of politicians without management experience of subject knowledge running a department with over a million staff, one of the largest organisations in the world.


This overcentralisation would seem to be made worse by the Agenda for Change which introduces national pay scales within the NHS, further centralising pay decisions.  This means that when politicians make mistakes, as they clearly did in the GP contract that has increased pay and decreased the amount of work done, their failure is exponentially more important.  Increasing the scale of the decision also increases its complexity which increases the chances of a mistake.

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