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

“The requirement,” the message read, “is not something we can control”.

That ominous announcement was sent to staff at Mid and South Essex Foundation Trust to explain that the organisation would be cutting around 600 jobs.

The trust faces a spiralling financial gap and needs to act quickly, according to a message sent to staff by chief executive Matthew Hopkins.

“If we do not shape the process ourselves,” the missive says, “the alternative is that this will be done to us with a complete freeze on all recruitment activity until the 600 whole-time equivalent reduction is achieved.”

Mr Hopkins was keeping mum on who issued the “requirement,” but the trust was just this month subjected to equally ominous-sounding “mandated intensive support” from NHS England on account of its finances.

Latest plans put the deficit at £100m, even after efficiency savings equal to 6 per cent of turnover.

The trust, which runs three major hospitals in Basildon, Southend and Chelmsford, is also reviewing recruitment to clinical positions.

Mr Hopkins told HSJ the trust had added 2,000 posts in recent years and now needed to look at vacant roles to see “whether they are genuinely needed” as part of its financial recovery plans.

On the day that HSJ published this story, NHS leaders in the Midlands challenged NHSE to choose between balancing the books and protecting patients.

Staffordshire and Stoke-on-Trent Integrated Care Board has taken the unusual step of publishing an analysis of the workforce cuts needed to get to a break-even budget.

The numbers are eye-watering: to eliminate the £130m deficit, the three providers would have to cut around a tenth of their posts — equivalent to more than 2,300 roles.

The ICB says this would have a “profound effect” and “bring our teams below safe staffing levels”.

NHSE is asked whether it would “support seeing staffing levels reduced in line with the available budget”.

Jon Rouse, an integrated care system member and city director of Stoke-on-Trent Council, said a one-year recovery plan was “completely and wholly unrealistic” and would do “significant damage, including… patient harm”.

It comes amid increasingly strained finances for the service, which is grappling with a £4.5bn projected black hole. NHSE is trying to fill the gap by pushing for workforce reductions, but local organisations are pushing back.

The Staffordshire report concludes: “We are expecting to reduce the deficit… but to go further would require service reductions. We would appreciate a conversation about these choices.” 

Also on today

NHSE has appointed a substantive chief dental officer after the post was held in an interim capacity for almost a year, it has announced. And we report that a GP has been named as the new chair of a community trust in the East of England.