November 2023: Engage Britain has now merged with Demos. You can still find all our work from 2019-2023 here, but to get in touch or find out about our new ventures, go to

‘Without enough admin staff it’s impossible. The whole system breaks down’

Our Health and Care Director, Miriam Levin, reflects on the latest sessions with The Patient’s Association and The Practice Manager’s Association

We recently brought together participants from The Patient’s Association to look in-depth at eight examples of communications good practice.

They took what they liked from those case studies and thought about what things would actually make a difference to the patient experience. They then had a conversation about what else is important to change, in terms of how the NHS communicates with people as they find their way into the system.

The main frustration that people with complex health needs shared was the impossibility of coordinating one’s own care. Having a long-term condition is a full-time job in itself. Having to check up appointments, track down results, be the person responsible for making sure that each doctor knows what the other doctors know… it shouldn’t have to be that way.

There was a real frustration that they are having to do all the work because the system isn’t talking to itself.

One of the key things they wanted to see was a single point of contact; a single point of coordination if you have complex health needs. But they also felt it was important they play a role in choosing who that contact is. So it’s really led by the patient, with a person they feel able to trust and have real confidence in.

This group also appreciated how, without enough admin staff – and without those staff being supported to do their job – it’s impossible. The whole system breaks down if you haven’t got the back-office functioning well.

One person told how their neurologist lost three admin staff over the last six months and is now doing all the admin themselves. When the neurologist is having to do the paperwork, it backs up the system all the way through.

Our sessions with The Practice Manager’s Association were the first time we heard from the staff perspective, which was brilliant. There was a real understanding about how difficult it is for patients to navigate through the system.

Receptionists try to help as best they can, but they get the brunt of the frustration and anger. As the front-line team, they’re having to deal with a lot of stuff they’re neither resourced nor trained to deal with.

They explained how training for reception staff used to be really good. They no longer have that training, yet are expected to be all things to all people.

To sum up, both practitioners and patients acknowledge the whole system is really broken. At the moment, patients feel the brunt of that because there’s nobody supporting them. But getting that to change is the challenge. And will have to come from the very top.