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Commissioning reforms redundancy count exceeds 10,000

More than 10,000 NHS staff have been made redundant in the past three financial years as a result of the government’s commissioning reforms, according to official figures published today.

New information was published by the Department of Health on Tuesday in its final “people tracker” document, which collects workforce information on the reform transition.

It also reveals that the proportion of those made redundant who are female was slightly bigger than the proportion of women in the overall commissioning workforce.

The people tracker is based on information from “sender”, which were abolished by the Health Act.

The tracker reported that sender organisations made 2,394 redundancies in 2012-13. That followed an estimated 5,600 in 2010-11 and 2,100 in 2011-12 - bringing the total to more than 10,000.

A further 3,841 left through “natural attrition”.

The DH’s initial estimates of the impact of the Health Act, published in January 2011, said there were 64,200 staff in affected organisations - mainly primary care trusts, strategic health authorities, and the Department of Health.

It expected 15,800 redundancies and 3,600 staff to leave through wastage. It suggests fewer staff have left than expected, although the DH has since acknowledged its own initial figures were uncertain.

It is also possible there will be further in commissioning staff reductions as a result of the reorganisation, as some were moved to temporary posts on April 1. Some were “lifted and shifted” to NHS England, and their functions could still be restructured.

Meanwhile, the people tracker shows 34,204 people in sender organisations in 2012-13 found jobs in the new system, in bodies such as NHS England, clinical commissioning groups and commissioning support units.

Although 68.4 per cent of the workforce affected by the transition were female, women accounted for 72.2 per cent of those made redundant.

The report says the DH “achieved a successful people transition process while minimising redundancies and maximising the retention of essential skills.”

Readers' comments (18)

  • 40% of FHS workforce to go as well over the next 2 years.

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  • The report says the DH “achieved a successful people transition process while minimising redundancies and maximising the retention of essential skills.”

    This sentence has to rate as the biggest lie since "the cheque's in the post"

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  • As the "people tracker" did not include staff who went under the Mutally Accepted Resignation scheme surely this is under reporting of the actual total who have left due to the reforms?

    Cannot say I know many who would see this as a "successful people transition process" as it has seen loss of great skill at great cost which will not be felt fully for some time to come - you only have to look at NHS jobs to see the cracks appearing in the difficult to fill posts

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  • In reality this has been an unmitigated HR disaster. Loss of talent and organisational memory, organisational chaos and confusion, personal misery and huge cost to the taxpayer. Did anything go well?

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  • Don't worry! Sir David Nicholson is still in post...

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  • And 9999 have been re-employed as interims at inflated salaries by NHS.....

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  • How many have been re employed? I personally know of quite a few who after a very short period have popped up again!

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  • successful ?
    not from where I am sitting (CCG by the way)
    the loss of what talent there was is remarkable - most obviously seen in the commissioning support units - looks like they got left with what everyone else didn't want

    nothing worth buying in there and ripe for take over - even if the leadership (oh yeah that's the former PCT bosses - at least that saved another big payout) cant see it and continue to spend our money on foreign trips - one this week - looking at things they cant possibly implement over here cos they simply haven't got the talent or the wherewithal !

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  • This could be a very useful £0.5bn saving if:

    1. Commissioning is no worse (hard to see how it could get worse than PCTs).
    2. These posts are not recreated.

    Whilst I'm sorry on a personal level for people losing their jobs, the NHS is not a job creation scheme and the jury is surely still out on whether the commissioner/provider split is worth the cost.

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  • Anon 1 May 2:24

    Sorry, but as someone that sits provider side and didn't have that many good words to say about commissioners in the PCT days I'm a long way from convinced that commissioning can get no worse. a lot of the work PCT's did wasn't great, but they were slowly getting better.

    Judging by the procurement documentation and processes that I've participated in so far this year, that have been led by:

    1 - The new local authority PH function in one case
    2 - NHS England in another
    3 -Two different CCG's in another two

    it's already got worse. Half written service specfications, MOIs that contain almost no information, unrealistic procurement timetables, unrealistic fianncial envelopes.

    Everything that was bad about PCT processes seems still to be there, it's just that there now seem to be a couple of seemingly disinterested GP's present at the bidder meeting and interview stages.

    As for the financial savings. £0.5bn? The one-off costs of the reforms range from government estimates of £1.6bn to independent estimates of up to £3bn.

    So between 3 and 6 years to pay off. Does anyone honestly think that CCG's will stay on the scale they are for anything like that long? Am I the only one that looks at them and thinks "I've seen you before but you had a different first initial last time around".

    How does it go? DHA's were replaced by PCG's that became PCT's, that merged and grew until they were the same size as the DHA's they replaced, that have now been replaced by CCG's ... that.... Well you can see where I'm going with this.

    Without a change of government.... I give it four years before we're back pretty much where we started.

    Whilst governments of all stripes love to bang on about the awful growth in bureaucracy of the NHS, the fortunes spent on managers and administrators, and all pledge to sweep it away, none of them seem to question how and why it has grown up.

    The simple facts are that if you run the system as a internal pseudo "market", that requires a bureaucracy to run it. If you think the Commissioner / Provider split is worth having and delivers quality and value, and all the major parties seem to believe that it does (although strangely no one seems too keen to undertake any kind of economic analysis to actually demonstrate the comparative benefits of spending money on this rather than directly on service provision), then that system requires resource.

    Twice we've allowed commissioners to build the resource that they considered they needed to do the job effectively. Both times they've arrived at organisations of a roughly similar sizes, administering roughly similar areas.

    We've done the "reform" and put in place a larger number of smaller organisations, with less resource before. What is it we think it going to be different this time?

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  • Well said anon 3.15pm

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  • What this headline should read is "DH Transition leaders cannot even do basic maths"

    64,200 people at the start
    34,204 people in the new bodies, so....

    29,996 people lost to the reforms

    10,094 redundancy
    3841 'attrition

    X New entrants to the NHS during the period

    Lost and unaccounted for by the report:

    Thats a minimum of 16,061 people.

    Here's the revised report:
    Over 47% of staff have left the commissioning sector due to the reforms
    We (the DH/NHS) can account for under half of those who have left.
    This has been the most disastrous reorganisation in NHS history.
    So we have paid off the leader responsible with over £1 million.
    But please, hard pressed public, trust us with your hard earned taxes.

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  • A Kleptocracy in action

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  • monitor are recruiting

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  • I left a PCT and ended up in a CSU as part of the reorganisation, I won't stay there because there is nothing attractive about the roles on offer for those who were formerly commissioners. Staff within the service are encouraged to adopt an item of service transactional approach, CSU leadership for the most part fondly imagines it is commercial but actually hasn't got a clue and the customer is still developing and may be struggling to define the approach it wants to see from CSUs.Effective relationship management makes for successful delivery, the current position is a recipe for a perfect storm.

    I really don't think that the way PCTs operated was always successful, and the worst of them were quite simply terrible. The good PCTs who worked in partnership with local clinicians made some significant improvements in care for patients. Sometimes PCTs made providers unhappy, I don't recollect any one ever saying to me it was my job to allow our local health economy to be ripped off by poor providers with inflated expectations and poor delivery - so not going to loose any sleep over that.

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  • Perfect storm indeed. In my old PCT, a lot of scores have been settled, and plenty over promoted, just like the old PCGs. Good people have left for providers, or other parts of healthcare, like VCOs. What's left is young, inexperienced or distinterested, with a handful genuinely good ones who will burn out with stress. There are better employers. I love the NHS and what it stands for, but can no longer bear to work in it, and that breaks my heart. I am effectively treading water and trying to learn new commercial skills until if or when it returns to some semblance of normality. But will it?

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  • Working in a provider all I can see is a merry go 'round of the same old commissioner faces in different jobs on inflated bandings with incomprehensible job titles.

    Don't tell me there still isn't a grotesque waste out there. Keep the reductions coming, reinvest the savings in real jobs on the front line.

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  • Commissioning is something you should do with a provider, not to a provider.
    Both parties should help to shape the new service: both parties have obligations to the other: both parties are responsible for outcomes, patient experience and value for money.
    True commissioning is collaborative, not competitive.
    Or it should be.
    At its heart is the word "mission" and that mission has not been articulated well enough by our politicians or leaders since the adoption of commissioning in the early 1990s.
    Commissioning never got going because it was never understood or welcomed by most of the NHS. Powerful vested interests rang rings round the weaknesses in the system; the centre was deaf to anything but good news; "payment by results" did not do what it said on the tin, and "QIPP" lived up to its acronym!
    Management consultants came and went with their fat fees, ineffective solutions and lack of accountability, just as clinical consultants did less than a century ago.
    We have not just lost people in the latest reforms - we have lost visionaries. They were literally "disillusioned" because the vision, or dream, or mission, had gone.
    Today the NHS is not dying. It is dead. It is on artificial life support while its organs (institutions, ideas and people) are harvested and sold. It cannot be re-assembled and resuscitated. It needs to be reincarnated.
    So we do not need transformational leaders to conduct yet another set of reforms - we need transcendental leaders to change the whole philosophy. We need to put the mission back into commissioning.

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