Daily Insight: Wanted: More good quality managers

The chief executive of a trust which has climbed off the bottom spot for accident and emergency performance nationally in recent months has said the NHS needs “more good quality managers” to deliver improvements.

Barking, Havering and Redbridge University Hospitals Trust had the joint lowest type 1 four-hours A&E performance in England in May, but has since moved out of the bottom 10.

BHRUT CEO Matthew Trainer told HSJ the recent improvements have been down to operational managers, and new same day emergency care services opened at the trust.

He said: “I think the NHS is undermanaged as a system. And I think if we want to become more productive and more effective as a system, I think we need more good quality managers.”

Emergency care has seen the biggest growth in staff numbers of any acute trust specialty in recent years, and experts have previously warned that “cramming” A&Es with medics while not investing in operational management has not worked.

Mr Trainer added he wants the trust to meet NHS England’s 76 per cent four hours target during 2024 – which he said would be “a stretch, but not impossible”.

Payroll problems

With doctors’ pay such a touchpaper topic this year, bosses at Wirral University Teaching Hospitals will have been tearing their hair out when they discovered dozens of consultants had been underpaid for up to a decade due to payroll errors.

HSJ understands the issue was raised by two consultants in January, and the trust has since been investigating. The issue relates to errors in the application of incremental pay progression which date back over a period of up to 10 years.

It appears to involve more than 100 doctors, with one source who asked not to be named saying the underpayments were “massive”, with some in the “tens of thousands”. They claimed the trust has been “dragging their feet in resolving the issues”.

Meanwhile, the British Medical Association’s national team posted a message on social media platform X (formerly known as Twitter) on Tuesday, accusing the trust of “denial, delay and obfuscation over resolving basic pay and contractual issues”. It suggested doctors were “working in a culture of disrespect”.

It added in a statement: “We have been advised that 45 consultants will receive back pay due to them in their August salaries, and the review of over 40 specialist and associate speciality doctors’ pay and contract issues is now underway.

“However, the pay and contracts of a further 20 consultants remain under review, even now, and we expect the trust to resolve this matter urgently. It has taken eight months to get this far, it must not take another eight.”

The trust said it was “extremely disappointed” by the social media post, adding: “We are working hard to resolve the matter and to ensure the correct payments are made. Pay is all highly individualised and complex, which is why we set up a dedicated contact from the outset for staff affected.

“We have written to all the consultants affected by the issue. We have apologised and we have met with our BMA local committee, who have been fully briefed throughout this piece of work. We have been completely open and transparent with our staff and with our BMA local committee, and we are working constructively to address the matter.”