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Commissioning board to 'lift and shift' staff

The NHS Commissioning Board is likely to delay some management cuts until 2013-14 and take on interim staff under emergency measures sparked by delays in the transition to new NHS structures.

The body has acknowledged it is unlikely to appoint to all of its posts as planned and may not have all staff in place by the time it takes on its full statutory responsibilities in April.

A paper due to be considered by its board today sets out contingency measures in response to the delays. Its national human resources director Jo-Anne Wass told HSJ she hoped these measures could be kept to a minimum, but acknowledged they were likely to be used to some extent.

The first measure is that instead of appointing staff to roles within the new structures, those currently carrying out particular functions - or on particular pay grades - will instead be transferred en masse to the commissioning board. The process is described as “lift and shift”.

As the new structures are meant to have fewer posts, that would mean in some functions there would be more people initially employed by the board than it could afford in the long term. Therefore further rounds of redundancies during 2013-14 may be necessary.
The second measure is that if posts are unfilled interim managers could be hired to fulfil tasks.

Ms Wass admitted to HSJ it was “most likely” some staff would be lifted and shifted by function - although the board is considering using a mix of block transfers and interim appointments.

It has already confirmed that family health service staff - who commission primary care services - and National Patient Safety Agency staff will be lifted and shifted.

A paper to today’s board meeting details difficulties with the lift and shift approach, including the additional cost of “greater numbers of staff joining the commissioning board” and that it would “necessitate rationalisation in 2013-14”.

Ms Wass said it was not yet clear how widely the practice would be used, and added that she was confident the costs of any redundancies in 2013-14 could be met via a combination of the board’s running cost budget and a one-off allocation of £108m it is expecting to receive from the Department of Health in 2013-14.

In the commissioning board’s risk register for this month, the possibility it will fail to fully populate its organisational structure by March is rated red, even after mitigation actions are taken.

Delays to the board finalising its organisational structure are cited as a key reason for the board falling behind on recruitment. The final structure was only signed off by chief executive Sir David Nicholson last month.

Ms Wass said her greatest concern was about filling posts in the operations directorate due to its complexity. The directorate will account for about two thirds of the board’s planned 3,500 staff, including regional offices and local area teams.

The approach to lift and shift could vary in different regions, Ms Wass said. She added that temporary staff would be brought in where it was “critical” the role was filled on 1 April.

“Some roles we might be able to leave vacant,” she added, as most organisations do not have all their roles filled all the time.
Managers in Partnership chief executive Jon Restell said: “It is better to lift and shift than rush a process and make lots of mistakes and risk treating people unfairly.”

He said that where more people were being transferred than would be needed in the new system, this would create “conditions of ongoing uncertainty” for staff. However, “you have to balance uncertainty with doing a proper job and a fair one”.

Mr Restell said he expected the areas where lift and shift would be needed were likely to be identified by mid-October.

Recruitment data released by the NHS Commissioning Board shows that its appointees so far are disproportionately likely to be white, male, heterosexual and aged under 50.

A paper to today’s board meeting shows that 97.1 per cent of staff appointed in open competition to the body by 30 July were classified as “white British” - even though that group only accounted for 84 per cent of applicants.

People aged in their 50s accounted for 48.3 per cent of candidates, but only 34.3 per cent of those who had been hired. Fifty-seven per cent of appointees were aged in their 40s - compared with 40.1 per cent who applied for jobs.

Heterosexual appointees accounted for 94.3 per cent of the total against 84.8 per cent of those who applied. Successful applicants were also more likely to be Christian or Jewish, and less likely to be Muslim, Hindu or “other”.

Only on disability did the board have a positive story to tell. Just 0.4 per cent of candidates had a disability, compared with 2.9 per cent of staff appointed.

Lord Adebowale, a non-executive director of the board who raised concerns about the impact of the transition on equality at its previous board meeting, told HSJ large organisational upheavals tended to favour white, middle-aged men.

Jo-Anne Wass said she believed performance would improve as further appointments are made.

Readers' comments (29)

  • This is a mess

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  • Interesting

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  • Very interesting, given the actual strutures show a 60% reduction in staff!
    Still staff will still have their say in the wait, they were done two weeks ago nationally with Machiavelli and the Unions.

    Great start NHS CB of encouraging staff to embrace the culture of the new organisation.

    Any comment?

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  • In my neck of the woods, it's hilarious. People have new job titles that made me laugh out loud when I saw the structures. Old wine, new bottles. Absolute farce!

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  • makes a change from rift and shaft

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  • My team and I have been assigned to the NCB as our receiver. We have been told we are to undergo job matching. The structure where our jobs might be has no posts because funding still needs to be clarified. This is before we compete for jobs with the other affected organisations. This is not a way to treat or value employees and is a complete disgrace.

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  • So the new organisation is likely to be simultaneously over-staffed and hiring interims (good luck finding those under the new regime btw).

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  • National unions? Because locally we maligned staff side reps have no say.

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  • When I was training, I worked on an alcohol unit for a while,meetings would start with a short verse from the bible, in this case I think a very short one would be applicable.....Gospel of John, chapter 11, verse 35.....'Jesus wept'

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  • Could the NCB have used a more demeaning phrase than "lift and shift". I think not. This is what they do to containers at a dock yard, or to pallets in a storage unit.
    The NHS is taking its last few breaths before it dies.

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  • The NHS is not going to die - those of us who have been in it for a long time have seen reorganisations come and go. The fundamental principle of good quality health care free at the point of delivery still stands in the main.

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  • At times it is a shame that this is a 'serious' journal, because some of the comments about the nonsense , sorry NHS reforms that are reported are only worthy of a "like" "unlike" and LOL : )
    I hear my parallel universe calling ever louder !

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  • I assume that the rest of the NHS will also be given similar ability to delay various cuts and efficiency measures until the new structure is
    a. appointed
    b. understands what government policy is (if this is possiuble)
    c. interprets what this means
    d. gives providers direction as to what it wants

    Should we wait in hope for the call? Life is so much easier when you can make your own rules!!

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  • and one wonders if any candidates from outside the "closed shop" of the NHS were appointed. From my experience it is nigh on impossible nowadays to break into the public sector from "outside", no matter how outstanding one is

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  • Glad I got out.
    What gives then the right to "play" with people's life!

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  • Anon 11.40, be careful what you wish for. I've worked in both the NHS and the private sector and the NHS is 5-10% "fact" (data, clinical evidence) and about 90-95% politics. Staff with long service in the NHS don't get treated well - just read some of the comments elsewhere. I miss some of the people but not the huge turbulence, uncertainty and bullying culture. You can still work with the NHS without the anguish of suffering through the above!

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  • I thought the NHS was not supposed to engage in these (unfunded) cosmetic surgical procedures?

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  • What this will mean for a PCT employee 'lifted and shifted' could be pretty dire. Instead of being made at risk across the transition period, with a multitude of posts in receiving organisations potentially available, they'll be facing redundancy next year, when all the other posts have been filled.

    What this will mean for the NHS is also pretty dire - the loss of a lot of good people who could have otherwise found useful posts in the new world.

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  • Too scary for words. What a mess. If the GBP had any clue about this....

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  • I suggest you all leave the NHS now. The NHS only learns the true value of an employee when it has to then contract them as a consultant!

    Come and join us. The water is lovely and warm (and chock full of payback!)

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