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Well lets see, where the hammer drops.....why not start wth managers and yes I mean most at every level! Numbers which have been going up from year to year dictates that managers should be the first to fall on their swords. I've been working in the NHS for almost 20 years and throughout my career have come to one conclusion and that is I've never understood how whilst year on year there are efficiency savings being made and yet the NHS has been increasing its management cohort for some unknown reason. Year on year we have more and more managers who walk around having endless meetings trying to look busy and all they get is promotion on the back of us frontline workers sweat and blood. You tell me really what efficiencies are being made by employing more and more managers in the NHS and especially ones that are brought in from outside industry to apparently improve efficiency, these people wouldn't have a clue, anything about what healthcare actually is and I've worked with many the last thing on their minds is quality so that one puts Ara Darzi's plans in outer space......what a load of poppycock....these people wouldn't know how to manage people if it came and slapped them in the face! Claw back the managers at every level......so there!