Maurice Dixon:

I believe many NHS staff still see technology as a potential threat to jobs including, taking away status as technology levels knowledge and reducing status by allowing more to be down further down the chain.

I harbour the same suspicions. As I previously stated, the NHS is a labour intensive organisation; technology has not reduces the number of staff employed in the NHS; and that healthcare may even be immune to automation and therefore does not follow the usual conventional laws of economics which apply to most other commercial and industrial processes.


The NHS is also a heavily unionised sector of the economy. I have long believed that both the political left and the trade unions are movements that are very good at demanding change but they are also movements who struggle to understand change, especially change as a result of technology. They are wary of developments in technology because of fears that it transfers more powers to the financial and corporate elite as well as destroying jobs for workers. I can remember a conversation with a left leaning individual about how internet shopping is killing bricks and mortar shops, and causing retail workers to lose their jobs. He said it's very bad although I tried to explain that internet retailing could possibly help British manufacturing that has been treated badly by bricks and mortar retailers since the 1970s.

 

However, taking on more responsibility must be reflected with more pay for those taking on more responsibility.

I'm not sure how this fits in with the NHS pay bands under Agenda for Change. If you didn't already know, NHS staff are allocated a pay band when they start a job and cannot move to a higher pay band unless a vacancy exists and they apply for it and succeed in the interview. Career progression is very much dead men's shoes, and down to luck (a suitable vacancy existing) rather than hard work, time served, or knowledge and expertise. It is very unmeritocratic. The only NHS staff outside of Agenda for Change pay bands are doctors and very senior managers.

Technology also is a threat as it can de-mystify the medical 'knowledge is power' status of some, and also expose the inefficiencies in current processes and departments. However, if technology can leverage more productivity, provide better work satisfaction, standardise medical interventions, deliver quicker medical treatment times, reduce waste in costs and resources, and automation of routine activity this will make staff, and thus the NHS, more effective and efficient. Technology should allow more nurse practitioners/paramedics to do more, and be rewarded for taking on more, to release consultants and surgeons to focus on the more demanding medical work, delivering more front line 'bang for buck', reducing bed blocking, reduce drug use, and getting people home quicker. We must find the win win scenario technology could deliver.

This is true but in a world where the NHS is not really in control of new technology (because it does not have much say or involvement in its design and development) and there are also deeply ingrained cultural and organisational issues inhibiting the deployment of technology in the NHS with the result that technology cannot be leveraged to its full potential and benefit to the patients, then technology can become an expensive curse rather than a cost effective blessing.


There are no bonus payments or rewards for high levels of productivity or excellence of service from nursing (or most other NHS) staff because of the way Agenda for Change operates. It reduces the incentive to go the extra mile or improve both productivity and quality of service that exists in much of the private sector.


Another problem is that the NHS is a reactionary rather than a visionary institution. It prefers to tootle along with no vision for the future (like a person who just lives for the present) but it reacts at lightning speed to anything from higher authority (like the MHRA or CQC) or in some cases bad press in the local newspaper. In a medical engineering department at a hospital, the management would not listen to the techs or implement their recommendations for change (progress and improvement, even if it originally came from the ward staff to start with, but anything from the MHRA and they would jump out of their leather chairs faster than a rocket.

However, too big a reliance on technology can be a high risk, as when technology fails and is not repaired quickly, staff can find it hard to fallback to basic non/low-technology working during a failure. Back-up processes, and resilient system design, need to be in place and practiced to reduce the loss of technology risk to delivery the NHS output.

A cynical argument for why they should still teach handwriting in schools. It's a known fact that a doctor isn't a real doctor unless their handwriting is illegible but, until the turn of the Millennium, applicants for nursing and admin positions in the NHS were known to have their handwriting examined.

Maurice Dixon:

I believe many NHS staff still see technology as a potential threat to jobs including, taking away status as technology levels knowledge and reducing status by allowing more to be down further down the chain.

I harbour the same suspicions. As I previously stated, the NHS is a labour intensive organisation; technology has not reduces the number of staff employed in the NHS; and that healthcare may even be immune to automation and therefore does not follow the usual conventional laws of economics which apply to most other commercial and industrial processes.


The NHS is also a heavily unionised sector of the economy. I have long believed that both the political left and the trade unions are movements that are very good at demanding change but they are also movements who struggle to understand change, especially change as a result of technology. They are wary of developments in technology because of fears that it transfers more powers to the financial and corporate elite as well as destroying jobs for workers. I can remember a conversation with a left leaning individual about how internet shopping is killing bricks and mortar shops, and causing retail workers to lose their jobs. He said it's very bad although I tried to explain that internet retailing could possibly help British manufacturing that has been treated badly by bricks and mortar retailers since the 1970s.

 

However, taking on more responsibility must be reflected with more pay for those taking on more responsibility.

I'm not sure how this fits in with the NHS pay bands under Agenda for Change. If you didn't already know, NHS staff are allocated a pay band when they start a job and cannot move to a higher pay band unless a vacancy exists and they apply for it and succeed in the interview. Career progression is very much dead men's shoes, and down to luck (a suitable vacancy existing) rather than hard work, time served, or knowledge and expertise. It is very unmeritocratic. The only NHS staff outside of Agenda for Change pay bands are doctors and very senior managers.

Technology also is a threat as it can de-mystify the medical 'knowledge is power' status of some, and also expose the inefficiencies in current processes and departments. However, if technology can leverage more productivity, provide better work satisfaction, standardise medical interventions, deliver quicker medical treatment times, reduce waste in costs and resources, and automation of routine activity this will make staff, and thus the NHS, more effective and efficient. Technology should allow more nurse practitioners/paramedics to do more, and be rewarded for taking on more, to release consultants and surgeons to focus on the more demanding medical work, delivering more front line 'bang for buck', reducing bed blocking, reduce drug use, and getting people home quicker. We must find the win win scenario technology could deliver.

This is true but in a world where the NHS is not really in control of new technology (because it does not have much say or involvement in its design and development) and there are also deeply ingrained cultural and organisational issues inhibiting the deployment of technology in the NHS with the result that technology cannot be leveraged to its full potential and benefit to the patients, then technology can become an expensive curse rather than a cost effective blessing.


There are no bonus payments or rewards for high levels of productivity or excellence of service from nursing (or most other NHS) staff because of the way Agenda for Change operates. It reduces the incentive to go the extra mile or improve both productivity and quality of service that exists in much of the private sector.


Another problem is that the NHS is a reactionary rather than a visionary institution. It prefers to tootle along with no vision for the future (like a person who just lives for the present) but it reacts at lightning speed to anything from higher authority (like the MHRA or CQC) or in some cases bad press in the local newspaper. In a medical engineering department at a hospital, the management would not listen to the techs or implement their recommendations for change (progress and improvement, even if it originally came from the ward staff to start with, but anything from the MHRA and they would jump out of their leather chairs faster than a rocket.

However, too big a reliance on technology can be a high risk, as when technology fails and is not repaired quickly, staff can find it hard to fallback to basic non/low-technology working during a failure. Back-up processes, and resilient system design, need to be in place and practiced to reduce the loss of technology risk to delivery the NHS output.

A cynical argument for why they should still teach handwriting in schools. It's a known fact that a doctor isn't a real doctor unless their handwriting is illegible but, until the turn of the Millennium, applicants for nursing and admin positions in the NHS were known to have their handwriting examined.