NHS admin staff keep services running - but we"re being hit by cuts

Secretaries, waiting list and medical records clerks, clinical audit facilitators, business analysts and IT technicians and other support staff pull together to keep essential lifesaving NHS services running smoothly. To a staff nurse, the help of a ward clerk to retrieve a patient’s medical history can be just as crucial as that of a senior consultant. Data quality officers ensuring patients are properly admitted and discharged on computer systems can have an immeasurable impact on the management of bed capacity.

Yet those of us in NHS support services work in less-than-ideal circumstances. I work in an office that is a converted ward. Save for wheeling out most of the medical equipment, it remains an abandoned clinical area. I’m always wary when manoeuvring around our cramped kitchenette – imagine the embarrassment of accidentally leaning on one of the emergency call buttons and having the rapid response CPR team come crashing in.

Plates and cutlery stand stacked precariously atop the tiny dining table and fridge (kindly donated by another admin department, who were throwing it out). A locked walk-in cupboard adjacent to the kitchen would be ideal for storing these. However, due to budget and staff restrictions, logging a job with estates to get a new Yale lock installed has proven fruitless on several occasions. Jobs deemed non-essential are often cancelled. With a leaking radiator pipe, broken window and an unexplained beep from above the ceiling tiles failing to see a quick response, reporting anything else can make one feel rather hypercritical.

The already cramped office still holds a partly dismantled bed hoist, condemned imaging machines and a box of surgical tubing, seemingly forgotten. We have jokingly discussed eBaying the lot to raise funds to buy desk lamps; dim strip lighting doesn’t quite work in an office.

I was lucky enough to suffer a full-scale-beyond-repair PC meltdown one day, so IT had no choice but to provide me with a reconditioned model from their storeroom. However, some of my colleagues are working on machines so old they take upwards of 20 minutes to boot up in the morning. The high-pitched whine of the struggling fans is maddening. Stretched IT staff struggle to keep up with demand. While problems with direct patient impact understandably take priority, waiting three days for a simple but essential fix is excessive.

For a team dependent on computers for their jobs, this can mean time wasted recording information on paper, only to have to transfer it to a digital source once systems are back up and running. It’s easy to see how this can contribute to huge backlogs and missed deadlines. Panicked managers pleading staff to take budget-stretching overtime is often the result.

Cheap or outdated equipment with a tendency to crash or throw up errors only adds to the problem. False economy reigns supreme, when an inadequate version is eventually replaced with the one we should have had all along. An ancient printer once cost my department half a day of productivity, as IT spent hours searching for a withdrawn ink cartridge so we could run off essential documents.

A friend in another department is responsible for requesting essential office supplies. To ensure he’s not buying luxury items the trust can’t afford, all orders are approved by executive-level staff. A recent attempt to gain a few pencil sharpeners saw 12 members of staff told to share three. Mouse mats are definitely off limits.

Understaffing is not just a problem on the frontline. Although there have been cuts and restrictions to what is made available, access to support and training for admin staff is still admittedly good, and it’s not uncommon to hear of a new recruit using NHS resources to gain experience and qualifications before handing in their notice to take a similar role in the private sector. Vacancies are often not re-advertised. While the wary jump ship, those left behind are expected to absorb the roles of colleagues, often without a wage increase.

I am proud to say I work for the NHS. It means much more to me than private sector benefits like a shiny new Apple Mac to work on or an all-expenses paid Christmas do. I enjoy knowing that I am, albeit in an indirect way, contributing to saving people’s lives. There is a sense of community in the health service I don’t sense in corporate organisations; we still join unions, strike together, are aware of each other’s problems.

Yet, just like the healthcare professionals feeling the stress and strain of the continued NHS cuts, we support staff feel we can do only do our best when we’re comfortable at work and morale is high. Since beginning my NHS career, although I’ve advanced and been promoted, I also feel that things are sliding backwards. While frontline medical staff are still undoubtedly in the most direct line of fire, we feel the impact under the surface too and there’s a definite feeling that things are getting worse.

• Some details have been altered to protect the identity of the writer

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NHS admin staff keep services running - but we"re being hit by cuts

I had to quit NHS admin – I felt like a workhorse flogged too hard

I had recently resigned from a well-paid job when I started working for the NHS in an administrative role. I was happy to be performing a useful service in the interests of a larger social goal, while no longer being required to write strategy documents or meet financial targets. However, in my seven months as a hospital specialty coordinator (a posh term for medical secretary, invented in order to create a sense of potential job progression), I experienced more stress – of several different kinds – than I have ever experienced.

The NHS is 25 years behind the rest of the country in terms of technology and management techniques

After the 2013 final report of the public inquiry into the “deaths by human error” at the Mid Staffordshire NHS foundation trust, the induction training programme for all new starters in the NHS – both clinical and administrative – was substantially rewritten. The major change in the day-long training sessions was the section on transparency and accountability. All new staff, we were told, were encouraged to follow the trust’s whistleblowing policy: this meant that we should feel duty-bound to report any incident, however small, that might jeopardise the wellbeing of a patient.

The NHS is 25 years behind the rest of the country in terms of technology and management techniques. Despite millions of pounds spent on computer technology in the NHS, I was amazed to discover that everything done within the health service – every clinic letter, investigative test, scan result – requires a hard copy file note to accompany its electronic counterpart. Across the country, hospital administrative staff, such as myself, waste thousands of hours each week trying to locate hard copy patient notes that could be anywhere within numerous hospital departments, and in many cases, across several different hospitals.

The most familiar sight in any hospital admin department is overloaded trolleys with patient notes being trundled from one section of the hospital to another, and overflowing filing trays that require staff to come in at weekends just so that they don’t start Monday mornings depressed by the amount of filing they have to do.

I could not work out why technological advancements and concern for the environment could have somehow bypassed the NHS, the fifth largest employer in the world. Jeremy Hunt’s goal of a paperless health service by 2018 looked to be a long way off, particularly since most of the managers preferred the security of hard copies (as back-up in the event of a computer glitch, and also in terms of patient confidentiality, since paper is not vulnerable to computer hacking).

Managers struggled to address the problems of their increasingly demoralised staff, who were trying to cope not just with the paperwork, but also with the constant demands of patients who wanted to know why their test had not been scheduled, or why they had not received their results. Absenteeism was rife because staff frequently called in sick with stress. On some days I found myself doing three people’s jobs. If a consultant was sick, their clinic for that day was cancelled. If a medical secretary, or two, or three, called in sick, the patients kept coming, and so did the accompanying paperwork.

I felt like I didn’t have time to breathe, let alone take a lunch break, and inevitably, when people are stressed, they take it out on each other. In my experience, the consultants, registrars and junior doctors were polite and considerate to the admin staff; and the patients were understanding and forbearing: it was the other admin staff who were the most unpleasant to one another. On one occasion, for example, a group of admin staff organised an official meeting to complain that their colleagues were “hogging” the few hours per week of a temporary helper.

Some managers tried a technological fix to the problem of overwork and paperwork – “two computer screens will make you more efficient by speeding up your processing times” – whereas what we needed was less absenteeism and better systems. We were, however, forbidden to use any external agency staff to cope with the dire shortages. These were considered an expensive luxury at a time of cost-cutting. Since all managers were assessed on their ability to achieve targets and avoid serious incidents, the real reasons for the poor performance of their staff were disregarded as long as no breaches of the trust’s policies needed to be reported.

In the end, I felt like a workhorse who was flogged too hard for trying and failing to shoulder the burdens of the job. I have left the NHS and am working in a job where I no longer dread the thought of Monday morning. I never reported a colleague through the whistleblowing hotline and, as far as I know, no one reported me. I can’t help feeling guilty, though, at the thought of the continued toil of my former workhorse colleagues I left behind.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

I had to quit NHS admin – I felt like a workhorse flogged too hard