The must-read stories and debate in health policy and leadership

ALB wields axe

The next two years will see a major shake up of the NHS’s national digital agency, with significant job losses expected, as exclusively revealed by HSJ.

NHS Digital told more than 600 of its roughly 3,000 staff on Monday that they would be part of the first wave of a restructure, known as “Org2”.

A further two waves are expected over the next two years, with staff asked to apply for fewer roles, including some new ones which they must compete with external candidates for.

NHS Digital declined to put a number around the job losses, but unions expect it to be in the hundreds. The reason for changes is two fold.

First, NHS Digital has inherited staff from legacy organisations with skills that no longer match the digital services it is expected to deliver.

NHS Digital needs more people with cyber security, data science and machine learning skills and less with project management, analyst and support skills (particularly in middle tiers of the organisation).

Second, the agency’s funding is projected to drop by nearly a fifth by 2020-21 and, with staffing the only major adjustment cost, shrinking the workforce is the obvious place to make cuts.

NHS Digital has told staff the status quo is no longer viable, and change is needed to remain useful to the system.

“We do not believe our current workforce meets these requirements,” NHS Digital said, in a document outlining the changes to staff.

Are you bothered?

What was the Big Secret behind a struggling hospital’s accident and emergency performance miraculous recovery from languishing at 81 per cent in July 2017 but topping 95 per cent just a year later?

Making staff “bothered” about the four hour metric and recognising it was a “quality standard not a performance target”, a senior trust chief has told HSJ.

Nick Hulme, chief of the newly created East Suffolk and North Essex Foundation Trust, said turning around Colchester Hospital’s woeful A&E performance had required a “little bit of [changing] systems, but was largely hearts and minds”.

His approach was inspired by a chat with a locum registrar who has worked in 50 NHS A&Es who told him that if “[the staff] are committed and bothered about the four hour standard then you deliver it, and if they’re not, you don’t,” he said.

“So I had a series of one-to-one meetings with senior staff and consultants and said ‘you need to be bothered’. People are now genuinely committed to the standard because they recognise it’s a quality standard and not a performance target. That took hours and hours of meetings.”

So, you’ve gotta ask yourself one question: do I feel bothered? Well, do ya?