The must-read stories and debate in health policy and leadership.
Trimming the digital tree
Like many arm’s-lengths bodies, NHS Digital has a patchwork history of mergers, name changes and shifting briefs.
The organisation has historically been focused on collecting and publishing NHS data. In more recent years, its brief has expanded to leading the national bits of NHS IT strategy.
A 2017 review found many people who worked with NHS Digital believed it wasn’t up to its expanded digital brief. Some said it wasn’t clear what NHS Digital was for.
That review precipitated a massive clear-out of staff which cost the organisation £11m in redundancy payouts in 2018-19.
During the year, NHS Digital reduced its head count by 304 people. By April 2021, the organisation wants to lose a further 200 staff, dropping from 3,000 people to roughly 2,500.
However, the net staff drop masks the true scale of churn at the organisation. Last year, 429 staff left, and 124 new people arrived.
NHS Digital doesn’t want to just downsize – it wants to replace people with skills it no longer needs as much of, such as project management, with people who can deliver on its expanded brief, such as cyber security experts.
Downsizing has proven expensive (exit packages for two departing staff alone cost more than £300,000), and will likely continue to do so, although costs will probably tail off in this financial year.
NHS Digital is not alone in giving six-figure exit packages to departing staff. Four directors who left NHS Improvement as it was effectively merged with NHS England have also received payouts worth between £150,000 and £300,000.
Former medical director and chief operating officer, Kathy McLean, received a “compulsory redundancy” payment – the only payout of the four to be labelled as such – of between £250,000 and £300,000.
Former director of improvement, Adam Sewell-Jones, also received between £250,000 and £300,000, while Jeremy Marlow, former director of operational productivity, received between £200,000 and £250,000, and Stephen Hay, former director of regulation and deputy chief executive, received between £150,000 and £200,000.
Big reconfigurations are always a lengthy process; drawing up a proposal, meeting NHS England’s requirements, consulting the public, and then actually implementing change can take several years.
Less willing to wait and see how things will pan out are the staff at threatened services, who tend to quickly move on to other opportunities. And job adverts for roles which may be moved or scrapped shortly don’t exactly attract a large number of high-quality candidates.
That’s what’s happening with Kent and Medway’s controversial reconfiguration of its stroke services, which will close three units and turn three others into hyper acute stroke units. The plan as it stands was to close the units in Tunbridge Wells Hospital and Medway Hospital, and open the HASUs in Maidstone Hospital and Darent Valley Hospital next March.
But staff shortages at Tunbridge Wells Hospital have now made continuing a safe service there unviable. More than half of the ward’s thrombolysis nurse posts along with three-quarters of its registered nurse posts are vacant, while ambulances are already being diverted to Maidstone Hospital overnight.
So, from late September, all stroke patients will go straight to Maidstone Hospital where an additional stroke ward will be opened. It’s a temporary move officially – and therefore does not need public consultation – but is unlikely to be reversed before the planned reconfiguration date of March 2020.