I am in no doubt that the NHS is being mismanaged and, to add insult to injury, the managers pay themselves a fortune for perpetuating the situation.
The matter of agency staff is a good case in point, but there is also the apparent need to import qualified staff from abroad. The simple reason for this, of course, is that the NHS has not been paying for sufficient training programmes for staff. I know; my wife works in a university department that does just that. It's simply lack of foresight and planning. They think they have enough staff so they cut corners by reducing staff training, then the next year they realise that they actually need more but unfortunately forget that it takes four years or more to train non-medical staff (and more, of course, for medics). The only option then is to import.
I remember the old days when there was a matron, ward sisters, SRNs and SENs in the nursing profession, and medical consultants made all the policy decisions. Now there is an army of nursing managers (latterly going under the title of Matrons in some places) who seem to spend their time either sitting behind a desk or wandering around with a clipboard. Presumably, this is necessary to deal with the overwhelming piles of paperwork which have, apparently, become necessary. It seems that the many non-medically qualified bureaucrats are unable to cope with all of the paperwork themselves.