• NHSE/I launch consultation on “phase three” of restructure
  • Total restructure exercise expected to reduce current structure by around 1,200 posts

NHS England and Improvement are beginning the third and largest phase of the restructure bringing the two organisations together, which is expected in total to remove about 15 per cent of posts.

They today launched a consultation on “phase three” of their joint working restructure programme. This phase covers all staff on Agenda for Change contracts or equivalents. The more senior staff have been covered in previous phases.

In total, the restructure – including all three phases – is expected to reduce the current number of posts by around 1,200, and estimated to deliver a reduction of around 15.2 per cent from the starting point.

According to the consultation document, the estimated number of people put at risk of redundancy today in phase three is 966.

The current figures are not final, in part because structures for the “people” directorate and posts linked to NHSX – the digital division jointly reporting to the Department of Health and Social Care – are not complete.

The document says the programme overall, including reductions in some non-staff budgets, will reduce annual national and regional admin spending by £95.6m – a 17 per cent reduction on 2018-19 spending.

A further cut of £50.2m – or 25 per cent of the 2018-19 baseline – is planned for programme budgets, which pay for work on service improvement schemes, among other things.

The document adds the reductions are inspired in part by the government’s “cap on combined administrative spending… which requires a real terms reduction in spending”.

However, it says the proposals involve “a greater reduction in corporate functions expenditure than mandated by government”. This allows “some reinvestment in new roles required to deliver the new organisation operating model”, such as the new “people” function. Conversely, it is thought some teams in NHSE and I are due to see post reductions substantially larger than the 15 per cent total.

The consultation document adds: “This model will be adaptive, changing over time to adjust to developments in the health system environment. For example, as local systems improve and transform, the balance of activities that take place in the regions and in the local health system may shift to ensure that services, support, regulation and improvement are all located where they best deliver improved care and health for patients.”

It also says: “At its heart, our new operating model will be built on the development of a new shared culture, set of values, behaviours and capabilities to support compassionate system leadership throughout the NHS.

“Internally, we will work to ensure our organisation is a place where our staff are supported to do their best work and we model the kind of supportive, inclusive, improvement focused culture and compassionate leadership that is required… Externally, through our regional teams, the tone of our interactions with the system will be focused on enabling, promoting, encouraging and supporting local systems to deliver.”

Where roles are removed, staff will be required to apply for ”suitable alternative employment opportunities”, with the document adding :”If no alternative employment can be found, then staff will be given their notice of their employment terminating by reason of redundancy.”

Staff consultation on the proposals will run until 29 August.

Annual reports for NHSE and NHSI indicate the number of staff employed grew overall at both during 2018-19. At NHSI, the average total staff number during the year to 31 March 2019 was 1,677, of which 1,249 were permanent. This compared to a total at 31 March 2018 of 1,369, of which 1,143 were permanent.

At NHSE, the average number employed during 2018-19 was 6,660, of which 5,866 were permanent; up from 6,149 in 2017-18, of which 5,278 were permanent. It is unclear how the number of staff jointly appointed between NHSE and I affected these figures.