This editorial is not meant as a criticism of the efforts being made by the centre or senior managers working at a local level. HSJ knows better than most how hard they are working and – in most cases – how effective they are being.
But, their very busy-ness means that sometimes things fall through the cracks.
It is clear from the NHS staff that have contacted HSJ that there remains confusion, and in some cases deep-unhappiness, over which non-clinical NHS staff should be supported to work from home and which need to travel to their offices and departments.
To state the obvious – the majority of NHS staff not directly involved in supporting clinicians should be working from home. There are exceptions, of course, it is hard to fix a hospital boiler or cook a patient’s supper remotely.
However, most managerial administrative staff can and should work remotely.
Many, understandably, have given in to the temptation to go to work to show support for their colleagues.
Do not do it. Put aside your guilt and channel your energy in working out how to make a difference from home – whether it be to the NHS or the vulnerable elderly person living at the end of your street.
More worrying is the number of messages we have received from NHS staff who have been told to come to work – or just as often – not told to stay home, despite the fact that with the right equipment they could easily work remotely or that they simply do not have any work to do at present.
The NHS – like many sectors – is not yet comfortable with home working. There are concerns over productivity, team cohesion and discipline, communication and whether the technology is up to the job.
Attempts to facilitate work from home during the crisis (eg allowing staff to take trust desktop computers home, and therefore avoid IT governance issues) are often placed in the “too difficult to sort out now” box.*
HSJ also detects a subliminal desire not to give admin staff whose project work is “on hold” a “free holiday” by sending them home. Hence the bizarre scenario of NHS staff being called to work for a 20-minute daily staff briefing (which could be done remotely) and then spending the rest of the day wondering what they are for.
Most concerning of all – are the tales of people’s symptoms being questioned – “that’s not a persistent cough”; “wait until you’ve got a fever”; “we’ll review your permission to self-isolate daily” etc. You would think this would never happen in the NHS – but HSJ has evidence that it is.
It is time to resolve this snafu. If the entire primary sector can switch from a primarily face-to-face service to largely remote one in just three weeks, then having administrative staff working from home as a default should be well within the NHS’ grasp.
The messages that HSJ has received have suggested confusion is greatest away from patient-facing hospitals services: in commissioners, arms-length bodies and areas such as data collection and analysis.
The common theme seems to be of a senior director or a chief executive dashing off a “please work normally” note to reassure people – and then some of their direct reports believing that, because they have not been given specific permission to institute working for home, their staff must be physically present in the office.
This is the wrong-headed – and, in most cases, not what the leadership of the service wants.
HSJ would argue that unless an individual has been given a specific reason why they must be in work, they (and their managers) should assume they must work from home if at all possible. Where they have been told they must come in – and believe that request is unreasonable – they should “blow the whistle” immediately and stay at home. Easier said than done, of course, especially with union reps busy elsewhere, but lives may depend on it and HSJ will actively pursue any cases that are brought to its attention.
Very good reasons will emerge as to why managerial and administration staff are needed on site as new ways of working develop. But better to have them safe at home while that is determined, rather than have them endangering their health and those of others by coming into work.
*HSJ suggests anyone who finds themselves in that situation, gets in touch with NHS Digital who are working hard to support NHS staff to WFH.
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