NHS Bureaucracy gone mad

Most of the time I will defend the bureaucracy within the NHS, and it’s usually because I feel there is a real and legitimate reason for it.  Take pre-employment checks:  these were initially introduced following Beverley Allitt.  Nobody wants any children (or indeed adults) to be exposed to such levels of harm due to an employee’s ill-health again and the rigorous pre-employment checks that the NHS undertakes is one significant step to ensure it doesn’t.

But last week, over a glass of wine with another NHS HR buddy, I learnt of about an NHS bureaucratic system gone mad:  all NHS Trusts are required to be insured, and this used to be called the Clinical Negligence Scheme for Trusts (CNST).     My friend’s Trust was aiming to get Level 3 accreditation (the highest level possible) of the new CNST – now called Acute Risk Management Scheme (ARMS). As a result the Trust would save in the region of 3 million.  These days, such savings are not to be ignored and after working towards Level 3 for the last 6 months, the Trust was successful in gaining the accreditation.

But it has been costly in terms of the amount of time invested by staff and the amount of stress involved.   But the worse part from my perspective is the futility of it.

Going back to the pre-employment checks – one element of the ARMS assessment is ensuring all staff have up to date professional registrations.  Most Trust focus on ensuring 100 per cent compliance.  It’s the outcome the matters, right?

Not with ARMS – it’s the process.  The key question that the assessors are looking to answer is – how is it monitored?  And…..wait for it…..who is monitoring the monitoring?


So my friend has spent many hours preparing monitoring reports of monitoring reports, that show how robustly professional registration is monitored.  She’s been so busy, she hasn’t had time to ensure that those with lapsed registrations are followed up and appropriate actions are taken (actually, it hasn’t been that bad – I’m just being dramatic)

But this is my point:  no-one within HR will ever argue about the need to be robust and ensuring appropriate monitoring is in place.  But the focus of these external NHS bodies should be on outcomes and not process.


One comment on “NHS Bureaucracy gone mad

  1. […] Blogger and NHS HR specialist Karen Wise, who fulminates against health service bureaucracy – such as the process that requires her colleague to […]

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