New data released today highlights challenges faced by National Health Service (NHS) trusts in monitoring connected devices and meeting compliance requirements.
Armis, an asset visibility and security company, obtained this data through a Freedom of Information (FOI) request to NHS trusts.
The findings reveal that NHS trusts face difficulties tracking and monitoring Internet of Medical Things (IoMT), Internet of Things (IoT), and Operational Technology (OT) assets. Mohammad Waqas, Principal Solutions Architect at Armis, commented, “The introduction of connected assets to healthcare is driving innovation and ultimately improving the delivery of care. However, its adoption has expanded the attack surface that now needs more oversight than ever.”
Of the NHS trusts surveyed, 15% acknowledged they are not tracking IoMT devices, while 20% rely on manual processes or spreadsheets. For IoT devices, 33% of trusts admitted to having no tracking method, and 10% use manual processes. Additionally, 10% of the respondents do not track OT devices in their environment.
The research shows that the lack of visibility and monitoring could not only increase vulnerability to cyber-attacks but also hamper trusts’ ability to comply with regulatory demands. Trusts need to know what is on their network to start complying, and this is difficult without adequate automation and resources.
In the survey, 38% of trusts stated that they do not have sufficient staff to meet the demands, and 23% lack the resources needed to replace outdated or unsupported medical devices.
When it comes to Data Security Protection Toolkit (DSPT) assessments, compiling evidence was cited as the most significant challenge. Although 82% of trusts can respond to NHS Cyber Alerts within 48 hours, many face difficulties in addressing issues within the mandated two weeks.
Waqas concluded, “Although the NHS is working hard, there are still crucial gaps that must be filled when it comes to addressing visibility, automating processes and satisfying compliance requirements.”
Recent Armis research identified nurse call systems, infusion pumps, and medication dispensing systems as high-risk connected medical devices in clinical environments.
According to a statement from the company:
“Recent Armis research identified the top connected medical devices that posed a high risk to clinical environments as nurse call systems, infusion pumps and medication dispensing systems. For information on how Armis can help address those challenges please email [email protected] or go to https://www.armis.com/nhs/. And, to understand how Armis’ new DSPT specific compliance dashboards and reports can enable simplification of the DSPT process see a 2 minute demo here.“
Armis will be attending Infosecurity Europe in London at the Excel Center on June 20-22, 2023 and will be located in booths W20.
This is the same organisation that fell prey to a ransomware attack because someone thought it would be a good idea to keep using Windows XP on internet-connected devices several years after the OS went out of support. I doubt IoMT is even on their radar.
Judging by the amount of NHS test results that dissapear into the NHS digital ether, I think they would be better off moving to typewriter and carrier pigeon, more bloody chance of results getting through!
My brother in law, sister in law and wife all had to get tested for the possibility of a hereditary heart condition back on February, all went on the same same day to the same General Hospital, no results, no letters, no explanation, apart from all blaming each other for the lost results!
Just “you had all better come back”…. Priceless, you couldn’t make it up…
I had surgery ( NHS funded) at a private hospital the other year and they now do all X rays, scans etc in house for NHS clients, because they got sick of the wrong thing being scanned, or just never getting (or waiting far too long) for the NHS results.
I had a doctor two nurses, a medical theater assistant (my wife) and a HR officer in my family. All now retired. The NHS have a lot of good people but my little crew could fill a book with the insanity that is the “modern” NHS. It has for all practical purposes had it and there isn’t one single politician with the balls to say so.
Very sad Geoff, I know of a few people who absolutely broke their hearts leaving the NHS for private medicine, one a seasoned mid wife and another long standing senior Nurse, both finally threw in the towel with the never ending insanity of the current culture and (it sadly has to be said) the amount of their younger colleagues swinging the lead and playing ‘the game’ for time off….
Hard working members of staff holding the whole thing up until they just burn out!
Far more “stress related” absences there days, funny how you don’t get anywhere near the same levels of absence in Companies that don’t pay sick pay…
If you pay people for months on end to stay at home with stress related headaches, guess what, stay at home they will!
I would sadly agree Geoff, the NHS as it stands today is toast, a vast bloated bureaucracy that’s out of control and haemorrhaging money.
Spot on.
Sad is the word John, and there is no one to fix it. There are ,I think, ways that help could be better targeted but in the end it’s just a huge money pit that will swallow what ever is thrown at it.
To my mind the first thing to do is remove politics. None of the political parties are ever going to fix the mess that the NHS is in and party politics should not be part of it.
I don’t what the format is. A Royal Commission? If I were Sunak I would stand up in the house and invite all the parties in England ( the other countries have devolved powers) to come together to formulate a five years plan of rebuilding the service.
I am not though holding my breath.
We should really use the defence budget to make sure the NHS IT systems are secure, clearly a role for our cyber warfare specialist here, perhaps then we can count NHS IT support toward our 2% of GDP on defence spending.
Jim wrote:
“”We should really use the defence budget to make sure the NHS IT systems are secure.”
I can where you are coming from, but for a completely secure network you have start at the lowest denominator. I left the army 6 years ago and we were just migrating over to the new MOD net intranet from the Defence Information Infrastructure. (Dii) Dii afforded users different levels of access and in order to gain those you had to undergo hours of a online teaching program (yearly) which culminated in a test and you had to pass each test to progress up the ladder. Here you learnt about basic security, phishing not opening strange emails, not sharing your details such as taping your logging details to the top of your monitor. You’d be surprised.
Also, and a big also all computers had their USB slots deactivated (and you had to have a damn good excuse in which have them turned on. As in a piece of paper) To have Internet privileges again you had to have a good excuse. Every month the network would change your password for you (9 digits) I once had a right go at a Lt Col who demanded I hand over my log in and my password so she could access my emails when I was on leave, I told her where to go citing chapter and verse. By being so anal, the military kept a short lease on its minions and in this day and age of state sponsored hacking that is how it must be, until somebody comes up with something better.
To that end why isn’t the same working practices put in place across the NHS, seeing as you are only as strong as your weakest link.
I suspect that’s the entire defence budget spent then. 🙂
This is the tail wagging the dog. The NHS should be setting standards (alongside other medical organisations worldwide) for security for systems & medical devices so that suppliers know that if they meet those standards their kit will be secure but also will be able to integrate easily within the medical environment.
There are Government agencies that I’m sure should want to lead the charge on this whilst leaving the medics to do what they are good at. 😀
We are in a new world now guys. Software on platform A can talk to software on any other platform securely. The NHS should not be wittering on about process and mega systems but setting frameworks for third party kit to work securely in.
NHS are exactly the wrong people to set these technical standards.
The police don’t.
Sorry Dave I should have been more specific. There are Government agencies who should be aiding and checking the technical stuff however the medical requirements should be set by the NHS. Once the standards have been set hardware and software suppliers should be able to move quickly to provide robust solutions for medical organisations especially the NHS.
The police have NEP, as provided by the Home Office – I believe.
Presuming it is the same thing.
This subject highlights the sense of apathy engrained not only in the ranks of the Political elites who run the country regards security (Be if Defence, Policing or in this case Computers and computer networks) and the average person on the street who whilst happy to purchase an all-singing dancing computer (On which they shop, banks and communicate. Are more than happy to have no anti-virus software or if they do will go for the free versions (which is better than nothing) but what makes this situation even worse for everybody is the lax security people subscribe to such as weak passwords, sharing passwords, visiting dodgy websites, downloading porn etc.
You’d think that after Estonia got hit by a mass cyber-attack in 2007 which shut down the country the rest of Europe would have woken up. But no, in May 2017 a global ransomware attack, known as WannaCry, infected more than 200,000 computers in at least 100 countries. In the UK, the attack particularly hit the NHS, (although it was not the specific target) with it affecting at least 80 out of the 236 trusts across England. A further 603 primary care and other NHS organisations were also infected, including 595 GP practices. But here’s the stinger, the Government had issued a warning to the NHS regards such attacks in July 2015 (almost a year before) but it gets worse, the cabinet office had written to the various government departments in 2014 telling them to migrate away from the now out of date XP operating system in mass use across government (extended support ended April 2014) by July 2015.
But did they listen, did they bollocks and they got hit by WannaCry, have they learnt their lesson? Have they bollocks seeing as in 2021 (4 years after WannaCry) 9 NHS trusts were hit by ransomware.
If NHS trusts can go out of their way to employ 800 diversity and inclusion officers, at a cost of £40 million a year. (As of Feb 2023) then why cant they afford to employ proper qualified computer security officers in which to safeguard the entire NHS instead. I mean which is more important somebody to berate others for not using the correct pronoun they, them, Xe (or even Cat) or somebody who ensures that computers and computer networks which form the life blood of the NHS are kept safe and continue to work despite the best efforts of others to close them down.
Pay peanuts, get monkeys.
Few people have the mentality to work for a public service for the sake of it, vocation is the term.
Everyone else, is expensive. Not many of those.
DW wrote:
“”Pay peanuts, get monkeys.””
If the NHS can hand over £70K a year for a diversity manager , they can afford to pay for somebody to look over their computer network. Not only that, but the NHS allows staff to retire and then has no problem rehiring them at previous wages whislt they receive their pension
https://i.postimg.cc/yY5PpVgq/Opera-Snapshot-2023-06-20-190205-www-england-nhs-uk.png
Contrast that with the army where if you leave after 22 years recieve your pension and then join up again as FTRS, you lose your pension (whislt you are back in uniform) and face cuts to your wages so you dont earn more than what you should be earning at the rank you left at.
My point the NHS has a problem with sound fiscal management
Cannot disagree.
You’re telling me Farouk, try no financial management!
It runs like an old communist block command economy department, money thrown at it to ‘ make it work ‘ if it doesn’t, throw some more and carry on chucking money until it reaches a size the economy can’t support ( nearly there now), then finally as it starts to collapse under its own weight,privatisation, as there will be no other choice but to break up this enoumous unreformed mega department….
What emerges is an NHS commissioning body,
(free at the point of use), sending people to private hospitals for treatment and a million NHS workers in for one hell of a shock and wake up call in the private sector!
Do I feel it’s the right way, no, but it refuses to be reformed and no government has the balls to reform it, so it will stagger on a while longer…
My guess is full privatisation by 2030….
Sorry that’s just not true..the NHS does not have money thrown at it..it gets very limited funding and it’s collapsing under trying to do to much with to little..we pay less per person per year than almost any peer….the private sector would never ever take on the health system at present cost envelopes….they want around 3-4 times more than the NHS gets paid…the government pay the NHS around 3-4k for a knee replacement…the private sector charge 12k. For a knee replacement… even this this is suppressed because people can still get it for free on the NHS…in the US a knee replacement is $50,000, ten times what we pay the NHS. infact the only district general hospital to be ever given to a none NHS provider to run (circle a private sector provider ) was handed back after a couple of years as they could not run it on the NHS budget.
Give me the private sector..I know what my skill set is worth it’s not suppressed by the government ( in counties with private systems I would be on £150k ). NHS consultants would be pissing the selves as they would be on 10 times what they are now. You on the other hand would be screwed as you will probably have to pay around 15k per year in insurance if you can get any.
Hi Jonathan,
Its an interesting one, as mentioned below, being an employee of the NHS brings many perks, way over and above the base wage and excellent pension, perks that are un-dreamt of in the private sector.
For the record, I don’t believe the NHS should revert to a service led private model, its a simple fact that it is going to happen, as the current rate of finance and (I’m afraid to say) poor performance, shows a model that’s not working and is steadily heading off a cliff.
£160 billon a year is no trivial amount of money, lets factor in the £10’s of billions in waste too.
I would say with confidence that if it was £300 billion a year we would see few improvements, the vast slow moving bureaucratic nature of the NHS would simply bleed away even more cash…
A refusal to implement a sensible public/private model and just stubbornly heading on in its current model will be its ending, I get no pleasure from saying that, its really incredibly sad.
I’m not saying this, my ex NHS mates tell me how its become such a toxic place to work.
Their stores of (generally younger) colleagues tasking ‘months’ off work with stress related conditions on full pay, while they hold the line and other swinging the lead stories etc beggar belief…
Like I said, the NHS (in its current form) is shuffling towards the cliff, I expect it to topple over by 2030….
John the NHS is the epitome of a public private sector model, the NHS as most people understand it does not exist its not a monolith it’s actually around 20000 companies and organisations bound by contracts, the vast majority of those organisations are private ( GP practices are not NHS organisations they are independent businesses). Out of hours providers are all private sector organisations ( NHS 111 is totally private ). The big issue are the hospitals..it’s a simple fact the NHS will not pay the money the private sector requires to run a modern hospital…we pay peanuts…160 billion is a joke in regards to a modern health system…Germany pays around half a trillion and as I said the US pays around 4 trillion…our .16 trillion is literally peanuts and more money would make a difference I can tell as someone trying to fix the system the only barrier is staff staff staff…we have to few drs and to few nurses..all the dicking around the sides does not remove this simple fact and that’s because we pay less per head on healthcare than our peers..than everyone else….all else is political BS to hide the truth.
Morning Jonathan, I appreciate your knowledgeable viewpoint, the bottom line is the NHS as currently structured and organised simply dosen’t work.
The NHS budget is interesting, as we push steadily towards 200 billion a year (we can expect Labour to do that).
It becomes unaffordable, especially in light of government wider ‘massive’ social spending and borrowing exceeding our GDP to pay for it…
If your viewpoint is right, then an additional 40 billion won’t do a bloody thing anyway, that’s quite something, an amount of money equivalent to our entire defence budget will do little to nothing!
That sir is the very definition of broken system.
Re medical insurance, let’s not forget we pay National insurance already, those of us how are employed on the average wage already pay hundred of pounds a month!
hi John the unfortunate truth is our system is not the profoundly broken thing it’s actually our perception of the cost of healthcare…we simply cannot accept how much it costs…that’s because our system is politically run and we get if free at the point of delivery, don’t get a bill and don’t understand how much or how little we pay for health from our taxes..if we want to have a western standard health system to the level of say Germany we are going to have to pay for it…as I said the Germans pay half a trillion dollars a year for their system….thinking we can get a modern western system for less than say Germany pay is functionally. Insanity…I don’t really care how the NHS is funded…but If we want a good system we are going to actually have to pay around .3 trillion…..we have been trying to get something for nothing from the NHS for 75 years and if you track how much less we have paid the NHS compared to how much an average European nation paid we have paid literally hundreds and hundreds of billions of pounds less…I know I cannot convince you but it’s the honest truth…we have starved the NHS and now wonder why it’s dead…the rout cause is not a system change it’s a change in our own view of you actually have to pay for what you get…in the case of the NHS the entire nation has been sucking at the teat without feeding the cow….and now it’s dead and not providing milk we are saying it’s the cows fault….if we buy another cow without feeding it it’s going to die as well…..
Morning Jonathan, many thanks for your interesting and always knowledgeable perspective….
It’s a rather grim perspective isn’t it, what’s to be done I wonder.
If politicians were honest about it, it looks like the way forward would be a wholesale reform of the NHS ( being honest about what we expect it to do and not do), privatisation of parts of it, coupled with a doubling of the budget thrown in….
Apparently we have upwards of 6 million economically inactive ( or close to) people in the UK, we have employed people paying large sums in NI payments a month and millions of self employed paying £150 a year etc….
I wonder if £140 billion a year extra could be raised from there, if not, from where??
Now that’s sorted, Social Care, who wants to kick it off 🤣🤣🤣🫣
Yes social care…another system in which the British public wish to pay nothing and expect everything….
personally I think we need to go down a social insurance system in which everyone pays into a pot ( not general taxation) that supports a completely independent health system…the health system sets the rates and agreeds what is provided for those rates with a Large national health forum ( that’s how Germany does it)…if you have a reason you cannot pay ( say you don’t have capacity, the government pays for you).
The health and social care are so interconnected they should be the same system and paid for in the same way with the same budget .( effectively social care is healthcare..we only separated it out because one is free at delivering and one is means tested) but feeding and washing someone is actually healthcare….
It does not really matter who provides healthcare as long as you pay for what you expect to be delivered and don’t let market forces anywhere near it.
Totally agree mate, political forces on both sides have kicked that ball down the road for years.
Time for a bit of joined up thinking by grown ups and seperate both Social care and the NHS from bloody politicians ….
The ex head of BMA stated the NHS will consume the entire UK GDP by 2070. Of course it will be unstainable long before that. But politicians can’t actually have grown up conversation on the NHS, its value as political capital is far to high. So my view is continue to suck others government budgets dry and damaging other parts of the economy before the politicians stop using it for their own ends and restructure it. But by then a lot of damage will have been done.
Unfortunately Expat..there is a simple truth we all want to live as long as possible…that means the demand for healthcare is unlimited….that’s why the US spends 4 trillion a year on it and close to 20% GPD the only limit the US put on healthcare is the individuals ability to pay…we place strict controls….but we as the public then expect unlimited resources…..I don’t really care what the public decide, I’m beyond it but at present they are being feed BS by Politicians and the media…you cannot have unlimited Healthcare requirements….while not paying for it….then wonder why your health care professionals turn around and say no more…it’s simply untenable to say the NHS is rubbish when your paying it sod all…then say we’ll even if we paid it more it would still be rubbish…if you went to Tesco and asked for your weekly shop to be supplied below the actual cost of the food Tesco would tell you to jog on….or Tesco would not exist. We have for the last 75 years insisted the NHS supply us with healthcare for less than it costs…then kick it for failing.
Yes but the NHS pension age is 67…this is basically to encourage the old to stay in work..this is basically to try and keep GPs and other senior clinal staff working..as it cost £200,000 to train Dr and then another 500,000 to get them to GP level…essential after other training each of those retired GPS is walking away with an easy million pounds of training…so if we can keep them for a few more years….it’s fiscally sensible to do so…quite frankly one of the armed services big issues is it’s inability to retain the knowledge and training of its seniors.
The simple fact is we are down around 50,000 nurses and 10,000 drs mainly GPS…that’s around 300,000 years of training. Or something in the region of £5 billion pounds in nurse training costs and £10,000 billion in training cost for Drs….since the government is not stumping up that cash and it’s take a decade to train the needed staff and the NHS is no longer competitive in pay internationally ( the U.S. is taking all the Drs and nurses as it pays three times more for a nurse and 10 times more for a consultant)….the only option is to bribe people to work into their late 60s and 70s…( I’ve seen colleagues work until they died in their late 70s because there was no one to replace them).
As for sound fiscal management Germany pays its health system half a trillion a year…the US pays its system 4 trillion a year we pay the NHS .16 trillion…essentially we have been having half price healthcare for the last 75 years.NHS management costs are 8 billion a year vs the U.S. system at around 1 trillion a year manage. Cost…quite frankly .the NHS has taken its final kick in the pandemic and everyone is moaning about it because it’s utterly failed..to be honest I’m feed up and have got to the point that I’m say yes privatise the lot….and let’s see how everyone likes paying 10-15k a year in insurance costs per person….then they would have the right to be critical…as it is every gets far far more than they pay for and I’m just glade I’ve only got a couple of years left to work in the NHS….because it’s just sad how the Politicians have muddled the waters of the reality and how utterly entitled the British pubic have become around what they think they should be getting for the sod all they pay into the health system…,vs the reality of what it actually costs….you don’t go into Tesco and only pay half the cost of your shop and get a shit on when Tesco tell you to pay the full amount.
let me tell you a secret…I’m trying to get services up and running and no one will provide them..they laugh in my face…that is where we have got to, the public will pay so little for healthcare the countries healthcare providers are now refusing to take on services….because: one the cost envelopes are insanity and two there are no staff willing to work in the services…the unqualified staff can now get more money working in Tesco and we have not trained the numbers of qualified staff..as a cost saving ( over the last few decades we have stopped building and repairing buildings and then stopped training the required number of clinical staff…as we were so far in the red, because of demand outstripping what the government paid for)…..the funding of the NHS is a national disgrace that no one will even admit exists…they justify it with well it’s inefficient…..it’s been the most efficient health service in the world for as evidenced by pretty much every piece of international comparisons ever undertaken for as many decades as I’ve worked in healthcare…it’s only slipped in the last few years because 25% of its bed capacity is taken up by people who cannot or will not pay for their own social care….and the social care system collapsed because the sector pays far less than minimum wage and your better off working in a shop.
The problem is cuts to training budgets in 2010 which decimated training and has left the service dependent on retired and imported clinicians.
I think for you look at total cost of employment between public and private sectors there’s not much difference. For instance for most in the private sector to get the same level of pension security as say NHS staff would need to sacrifice bigger portion of there salary. NHS pays a whooping 20% into the employees pension. Private sector employers pay 3%.
Another example is 33 days annual leave after 10 years that’s 25% higher than the private sector which normal gives 25 days irrespective of time served. Then there car loan deals, the blue light card, remember if you save 1000 quid on purchases someone without the discounts need to earn around £1300 more to buy the same thing when you include tax and NI. Lastly full sick pay for 6 months, rest of us are entitle to £109 a week.
I don’t begrudge any of the above just highlighting its more than just pay packet. Comparably I’d say if your on 40k before tax in the NHS then in the private sector you’d need to earn 50k+ to match the benefits.
https://digital.nhs.uk/careers/core-benefits
As an aside I found it amusing that most of cars offered on NHS fleet solution where not made in UK. You’d think tax payer money should fund UK made products. Or I guess that only applies to defence 🙂
Agree with most of that.
Although, we have technical posts unfilled in our part of the public sector, for over five years.
When we train people from scratch they run off to the NHS.
People leaving for the NHS in droves.
We cannot get even CCNA qualified people to come to interview, CCNP – Ha! Ha! Ha! Ha!
Hi Expat, NHS fleet solutions is not really a benefit, when you compare it against normal deals it’s no better or worse….the big issue with it is the NHS no longer pay you a reasonable mileage figure….I don’t actually know anyone who has a car from fleet solutions….TBH…the only time it’s actually any good is if your a higher rate tax payer and you take salary sacrifice and go for an electric car……most of the benfits on that website are simply private sector offers to generate sales from a big group of people it’s got nothing to do with the NHS ( apart from the fact HR clicked that business offer NHS staff some discounts and published it) so the blue light card is just a way to access offers that every tends to get….BQ have a card and discounts anyone can get hold of, they are no better or worse….Christ my MFI employment package pisses all over the NHS one when I was selling kitchens for a living…..so when I when off to train as a nurse this was the differences between the NHS and MFI.
Pension NHS 1/80 final salary..MFI 1/56 final salary ( pissed all over the NHS offer)…and to rub salt in the NHS pension cost more.
private healthcare..NHS nope…MFI yes full cover
accident cover…NHS give me a laught…MFI yes full cover
christmas party..NHS pay for your own….MFI work organised Christmas parties
Discounts NHS not a chance…MFI 20 staff, friends and family discount up to 2 grand a year.
share dividend and purchase..NHS ha ha..MFI have some shares mate.
Christmas’s bonus NHS ha ha..MFI you’ve done well lads here’s 100quid in you pay.
proffit related pay: NHS more work work harder…MFI more work more proof it have a bonus the stores done well.
finally when i left MFI I spent 3 years training as nurse working on wards for 2000 hours for no pay…to qualify and finally when in working in ED saving lives, working night shifts, getting attacked, telling people their kid was dead I got paid 15% less than when I sold crap kitchens…….but I did it because I wanted to and we did not have 50,000 staff vacancies and I was not destroyed within a year or qualifying ( that’s what is happening now).
Didn’t MFI stand for Made for Idiots 😀. 20 years ago you would have good pensions etc in the private sector, That’s all gone now, there’s some outliers who still offer better than average benefits, mostly to existing employees. And also people like me lost pension in the private sector because they went under, lost my first 10 years of paying into one scheme then the fund went under, on paper it offer 2/3 final salary.
My job, company pay 3% pension, that’s it, No option for a discount card at all. Get a car allowance but its taxed so the amount you pay doesn’t cover the costs. No overtime as salaried . 25 days a year holiday + bank holidays. Statuary sick pay of 109 per week and companies discretion if they pay more than that, generally they’ll pay full pay for a few days off but after that forget it. Good motivation to stay healthy though 😀. They offer BUPA but its taxed so to protect take home pay I don’t take the benefit. I have to put loads into may pension from my side to even have any chance of a decent retirement, which hits my take home.
The government states you should get 45p per mile for first 10k then it drops, I’d be surprised if the NHS paid less than governments recommended amount, Some companies reduce it if you take the car allowance its not unknown for the it to be 11 or 12p when you take a car allowance, which didn’t even cover the cost of fuel at it peak.
I think we sound like a Monty python sketch, when I were a lad 😀
https://www.youtube.com/watch?v=1by0-nkKOTs
Indeed it was better in our day… re the car..and dropping the allowance, that’s what the NHS does…I cannot remember exactly what they drop it to…but it’s somewhere close to that 12p per mile silliness…add in the car tax costs…it’s just giving the government some money…which is why no one takes the NHS lease cars…As for MFI, they were honest to god a really good company to work for….lots of life long staff ( I even did part time sales work for MFI when I worked for the NHS as they paid better in the early days of my nursing career…5 days for the NHS and 2 days for MFI…..and the Staff discount was a great way to furnish your house).
I think the NHS has lost its way , more and more staff joining straight from universities …. Nurses now needing a degree , coming out with huge debt and wanting huge pay rises
I doubt that technical support staff join straight from universities, if they do, competence is the problem.
Yep and that’s the basic standard, modern nursing is a profoundly complex role….that degree provides nothing more that the essential requirement of 2000 hours practice and 2000 hours theory to give you the foundation stones only..it actually takes around 5 years to get a reasonably competent staff nurse who understands their specific specialty…you need another 5 years for a enhanced role nurse and another five years after that for an advanced practitioner. Nurses actually really only want the same sort of pay as Tesco workers have been given…. If the health system was a market driven they would have had it by now.
Will they drop the NHS benefits to match Tesco? I don’t believe Tesco pay 20% into their employee pensions or provide 33 days leave after 10 years or will the NHS drop sick pay to 16 weeks (1 week for each year up to 16 years service!)? If I’m on 40k at Tesco I need around 46.5k to match the pension contribution alone. Another 2k for the extra leave.
Better measure would be cost of employment which includes all the benefits. If NHS staff want the same deal (pay + benefits) as the private sector they need to be careful what they wish for.
I’ve worked all my life in the private sector and still can’t afford to retire, most in the NHS have long retired at my age!!!!
Interestingly Tesco had a defined benefits pension scheme open well after the NHS closed its scheme..that last NHS defined benefits scheme closed in 2015 Tesco closed their final salary scheme to new members in 2021/22.
As for who pays what. You have to remember that there is no NHS pension fund…the money that is paid in that years contributions pays the pensions for that year and then any excess money is sent back to the treasury…so last year 10% of the money was sent back to the treasury. As for contributions, you also have to remember that Tesco employees pay 4% to their wages to the Tesco pension scheme and NHS employees have to pay a lot more, I personally have to pay 14% of my salary to the NHS pension scheme, very few other people in this country pay so much. So yes it’s a good scheme ( career average not final salary) so I pay around 3 time more into a pension that most people.
As for days off yes Tesco are low, but companies like BAE tend to be pretty close to the NHS. I know a lot of NHS employees who have moved between BAE and the NHS and the consensus is that BAE is a better employer in pay, benefits etc.
As an example the NHS never ever pays overtime, infact it generally pays you less per hour the more hours you work. As a charge nurse on a ward if your ward needed covering and you did an extra shift you would not get paid at your rate ( band 6-7) you would instead be paid as a separate job ( with all the extra tax implications ) at the lowest possible rate a nurse gets ( bottom band 5, same as a newly qualified nurse)…the very best deal you can get in the NHS is they will give you time lue at a future date Tesco don’t do that they pay overtime. During the pandemic I worked 70-80 hour weeks and got exactly zero extra pay ( I was payed a 37.5hour week) I did that for 8 months effectively not being paid for around 1100 hours of work. As a nurse in ED and on wards I was expected to work extra on very shift ( infact I have probably given the NHS an extra few hours a day for 25 years…with never ever any overtime…this equates to literally 10s of thousand of unpaid hours over the time I have worked in the NHS ….and that’s almost every healthcare professions story…a paramedic does not go off shift until his last patient is delivered to hospital…he will be called to go to a 999 call literally up until the last second of his shift…that’s hours added onto a 12 hour shift…they will not get paid for that. The NHS is effectively depended on its staff providing this vast pool of unpaid work….Tesco pays overtime.
if we are really going for it…as a nurse I have to pay 120 pounds a year just to stay a nurse….I pay that. The NHS even charges its nurses to park at work…does Tesco make you pay a fee every year to be a Tesco worker ? Or charge you hundreds of pound a year to park in its car park when you are at work ?
As a nurse I have to re register, I’m expected to source and evidence 35 hours of study, get 5 sets of feedback and Also write five reflective accounts ( five short essays)..I am expected to do most of this in my own time…. That’s just for the pleasure of working for the NHS..
if NHS staff got the same deal as the private sector it would mean that we were subject to market forces….I assure you health systems that use market forces to dictate how much healthcare cost and how much health care professions get paid are far better for healthcare professionals that working for say the NHS …Goverments have to actively suppress health care worker wages..to Make health affordable…the systems that don’t do this, simply don’t provide adequate healthcare to its population or pay a fortune….in the states healthcare professionals earn many times the amount NHS healthcare workers do….nurses around 2-3 times more ( in my case if I moved to the states I would be earning 3 times the amount i do here) consultant surgeons earn around 10 times what they do in the UK…a UK NHS consultation earns around 97k a year, they tend to do private work part time that’s nets them around 200k…a consultant surgeon in the US earns around 3 million.
just using a knee replacement surgery:
NHS charged £3-4000
UK private hospitals £12-1400 ( this is suppressed as most demand is fulfilled by the NHS)
US healthcare providers $50,000 dollars ( market forces are king)
simply the world is short of Drs and Nurses..someone like me takes decades to train up and quite frankly my skill set is rare as rocking horse shit…even a newly qualified nurse is a rare resource in by demand and average staff nurse is payed between $77,600 and $120,00 dollars depending on shill shortage…( US nurses also get free private healthcare and)…one of the reasons that the UK is short of 50,000 nurses ( just for the NHS) is that we are not internationally competitive and nurses are going to the US and not UK.
Market forces in healthcare are simple and utterly brutal…there is no competition, no way to create efficiency of scale and no choice ….would you like the treatment or would you like to suffer and die…we are charging this much the next hospital is and hour a way and they are going to charge you whatever they want as as well….so are you getting your check book out mate or could you just go and die outside please….as there are a 10 others who need to decide if they are going to pay up be saved….in the states many people simply die because healthcare is so costly…health insurance is the biggest household expense in the US it costs a person around £450 dollars a month per person in the house hold.
The US private system charges the US 4 trillion dollars a year…yes four trillion dollars…4 thousand billion pounds…vs the NHS budget of 160 billion….yes the US pays its health system 25 times more that the UK pays the NHS…so yes please let’s go private…market forces all the way…..
By the way you all complain about NHs management costs the NHs spend 8 billion of its pathetic budget on manage and admin cost…the U.S spends 15-30% its budget on admin/management costs and the thats around a trillion dollars…1 thousand billion.
I like all my colleagues who have worked their arses off for decades to support and underfunded system..and work loads of unpaid hours because that child needed morphine more than I needed to go home to my own kids are now utterly done with the how the public think the NHS is over funded. We all want you to have the health service you deserve, but that means you are going to be very poor and pay the full cost the market would demand that’s is probably half your household income and if your really Ill your house and everything you own. Health care is the most expensive and complex endeavour in human history we all now live lives of unemagined comfort and length ( you and I would have likely died in agony in our forties 100 years ago)…but the biggest failing of the NHS is that the British public now somehow think it should not cost a measly £3000 pounds a year per person for the service they have….and the NHS is somehow ineffective..when a market driven system would actually cost them £16,000 ish a year each for their whole..life and take their house if they ever had a long term condition.
and one final rant….the NHS has to many managers……the NHS workforce is made up of around 2.5% managers…the UK workforce as a whole has 9.5% managers….and yet a health system is the most complex system ever created by humanity.
That was some rant. Notice I never said people don’t deserve more but I wanted to point out that its not apples with apples. Yes some employees get overtime. Generally hourly paid get overtime but salaried employees don’t, I don’t. If a customer calls I have to answer or get involved in work issue out of hours then I work. Loads in the private sector work extended hours without pay.
I have been in the situation where I have had to pay from my own pocket for a relative who was very ill it was a 5 figure sum, my family are not all from the UK. However this was the result was also the result of a failing public health system as much as private system.
Having had that experience you think i’d be 100% public service but personally I think we should go private for some things with core critical/chronic care being provided by the state. There’s far more appetite with employers to pay than is realised. Most employer go for insurances that provide annual checks ups helping employees understand their health and early get diagnosis, which as you know is critical to successful treatment. And 14k for knee op is nothing if you loose a key person from your business it could cost far more. Anyhow why shouldn’t an employer pay for ops that are more than likely a result of the job. You could say well the employer should just pay more tax to fund the NHS, but that doesn’t give them any reassurance that the employee will be a priority, after all the NHS wouldn’t prioritise Joe the engineer over retired Mrs Miggins for a knee op.
Another problem is we tax private medical from employers as a benefit so people like me refuse to take it as it hits our take home pay, thus the government inadvertently increase the load on the NHS. This tax is self defeating and the only reason its there is politicians think it only really wealthy people take up private health care so heck we must tax it. We really need to stop thinking of one system for all and all conditions. We don’t have to follow USs system or any other country. We should take politics out of it and design a hybrid system which delivers results.
Politician use the term 2 tiers system which is incorrect if system A removes pressure from system B then system B will be able to perform better = better services for all. Again its politicians out of date thinking preventing us moving forward. Generally people don’t mind paying more but the perception is increasing taxes will not provide them will any reduced waiting list or service improvements. We have no debate in this country about alternatives to improve, its shut down.
We’ve also over the years driven growth by increasing population adding people to increase GDP. If I add a person you need to provide healthcare (and other services), if I grow GDP with the same number of people then I get more tax revenue but I have don’t have more people to look after. More tax revenue and same volume of people to look after solves the NHS problem provide more funds and no additional patients. If you really want improvements in public services then vote for a party that has net zero immigration and increasing GDP as a policies. But unfortunately that’s not an option.
As for loosing my house, the likelihood is there will an inheritance tax raid and capital gains tax raid within the next 10 years so you either loose it before you die paying for private care or after to the government.
Personally I think the funding by taxation is the busted model because politicians will simply not tell the truth and convince the public they can have a Bentley for skoda money….I would like to see a system such as Germany when an independent body sets the compulsory insurance costs and what you actually get for that…Germany still controls its costs so it does not let market forces rip as the US system does but it provides realistic funding to the health system ( half a trillion ish not the fantasy amount the Treasury make up or the fantastical service requirements the DOh make up…
I also don’t disagree that we should support people going private if they can…I personally think they should get tax credits or some such payment for not using the NHS ( so if it’s cost the NHS £4k for a knee…giving the person couple of grand in tax breaks for using a private provider is sensible…oddly when I had private health insurance it actually paid me out a load of money for using the NHS so it did not have to stump up a private bed).
you also have to remember the NHS does use a mixed economy model..your GP practice is a private business with a contract with the NHS to provide you with care…it’s the same with out of hours..infact the only provision in the NHS which is state owned is generally hospital based provision and that’s as I said because the private sector will not accept NHS tariffs or run emergency care….the only hospitals based care they will do is planned surgery…but even then they charge the NHS far more than the NHS pays an NHS provider to do the same thing ( this pisses NHS trusts off no end ) .
you also have to remember the other big drag on the NHS is social care…25% of our hospitals beds are filled with people who should be at home but there is no one to take care of then ( washing, dressing eating etc)…
If you cut through all the BS the basic facts are:
1) we have far less Drs than the EU…we have 2.9 per 1000 people, the EU average is 3.9, Germany has around 4.5.( this is crippling..you cannot do healthcare without Drs.
2) we have less nurses than EU..7.9 per 1000 people vs 8.2 per 1000 EU average and places like Norway have 18.00 per 1000, Germany around 14 etc…only the old eastern block countries have similar figures to the UK we are more Bulgaria than Germany…again you cannot do healthcare without nurses.
3) hospital beds the Uk has around 2.4 hospitals beds per 1000 people vs Germany at around 8 per 1000 and France at 6 per 1000…the truth the government will not tell is that is why they locked down so hard…we did not have the bed capacity to manage a pandemic….without being utterly draconian….
4) the NHS has 10 billion pounds of outstanding repairs on its estates…. Because of saving money in year..
5) the NHS has 50,000 registered nurse vacancies…that’s around 5 billion in training costs to train that number of nurses.. we just never spent it…
6) the NHS has 10,00 senior Dr and GP vacancies…that’s around 10 billion in training costs..we never spent..
7) we lose around 20,000 bed days a day on patients who are not sick but are awaiting social care to be paid for….because we will not pay for social care….Tesco pay more per hour
These are the actual hard figures as to why the NHS is failing…..everything else is in reality smoke a mirrors by politicians and the media that support them….all we actually need to do is get our Dr numbers up by an extra 1 per thousand, have an extra 5 nurse per thousand. Get another 4 hospital beds per thousand people……as well as pay social care staff the same as a supermarket…funding an extra 13,000-20,000 social care bed days a day…..do that and you fix the system…but that costs well it costs around half a trillion a year..ask the Germans….
The simple fact is the NHS is damed to hell and back for spending money on management costs…surprise Surprise if you don’t have IT, information governance and digital security management..you get this. Essentially the NHS is pretty much entirely focused on managing sick people today and very little else at the moment…because that’s what the Government has told it to do ( the government are actually are accountable for the NHS and tell it what to do and how much money it has to do it and how that money will be spent, and it’s not telling us to spend on IT security experts or giving money for this). …is the NHS unable to manage its information governance….yes because it has billions of records and have to manage many billions of set of information about 70 million people moved around thousands of organisations…across millions of different devices….and we employ handfuls of people to manage this for each of our nhs systems (each system covers around a milllion people). Once HMG did try to sort this..they handed 12 billion pounds to the largest and best information tec companies in the world to develop a single secure record and information system….they look at the problem for years: the number of organisations, legal frameworks of passing information, the number of records, number of contacts , type of information, number of systems etc…and simply took the money and after a number of years came back and said it was an impossible job and could not be done. If the largest and best IT organisations in the world with almost unlimited funding ( 12billion pounds) could not do it…asking individual NHS providers or GP providers to do it with no extra budget is just asking for failure.
The problem is the government and always will be. The reality is these issues are solved in other countries and large organisation and there’s commercially available systems that will break the back of the problem meeting 95%+ of the requirements. I worked for a larger private sector company who had 400 systems connected and millions of transactions between them daily.
I suspect the issue is the same as the MOD’s – bespoking and gold plating requirements meaning off the shelf system don’t fit or need to be heavily customised = large sums of money and adding new feature compromises the original design and architecture = more money. The difference is because it NHS it doesn’t get the same level of criticism, its political suicide to mention anything negative about the NHS, as for the MoD, its open season.
Expat that 400 systems and 1 million transactions a day, its litterly insignificant compared to the scale of the data issue..NHS in England alone is made of of over 20000 different organisations and companies..and many of those will have many hundreds of systems…. there are 570 million interactions with patients in any one day..creating a number of different records and exchanges of information that’s trillions of set of information exchanges each day every day 24/7..not only that as the NHS is not a single organisation but around 20000 organisations it’s in constant flux with the systems undergoing massive changes every day. Simply put healthcare systems are literally inconceivably complex when compared with any other industry or sector…people just cannot really get it…I’ve spent 25 years working in the sector from hospital kitchens to overseeing the care of a million people…I’ve got 3 degrees and I don’t get it and learn something new everyday and what I knew yesterday as fact has changed today……no one understands it…no one can..that’s the problem and not just faced by the NHS,but faced by every healthcare system…..healthcare is the greatest most complex and expensive endeavour in human history…getting to the moon cost the US about 9 billion a year for a decade..in modern money…so 90 billion..that’s about the amount of money the US spend on healthcare in just over a week ( they spend about 77 billion a week on healthcare)….
I don’t doubt what your saying but I doubt all those system need to be connect in real time. Secondly you don’t actually connect each system to each other, modern enterprise service bus(ESB) will drastically reduce transaction volumes, a source system will send one message to the ESB the ESB sends it on to the required systems. So lets say an address change, this gets sent once not 20000 times to 20000 systems this vastly reduces the load on the systems. if you like have a bit of read up on ipaas technologies (Mulesoft, Tibco Boomi)
Hi expat the biggest problem is that because it’s healthcare information we are not actually allowed to automate sharing, there alway has to be a human in the loop of every information transaction making decisions on what should be shared using legal and ethical framework…..as well as ensuring the patient has given permission….this is what really breaks the system to be honest..also the type of information to be shared and who with…will change with each and every transaction. The other big problem is that people don’t really understand that the NHS they think exists does not, there is no real national health service..it’s a conglomerate of different provider and commissioning organisations that are contracted to provide services…of the 20000+ companies and organisations the vast majority of these are private sector organisations that have a contract with the “NHS” this allows them to use the NHS brand. They can generally provide those services as they see fit as long as they stick within the KPIs and contract..that includes using whoever they wish as their IT providers as long as that provider is accredited and on a list.