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

Senior managers are being lined up as NHS England kicks its voluntary redundancy scheme into high gear.

Details seen by HSJ reveal plans to remove roles that are “not required in the future”, and in some cases, employ “fewer senior managers” in certain areas.

It comes as NHSE seeks to cut its staff headcount by up to 40 per cent and help “minimise any need for compulsory redundancy”.

Those covered in the initial phase will include senior managers, but also staff working in its new transformation directorate, some of whom previously worked for NHS Digital or NHSX.

NHSE officials are keen to retain those with “specialist technical skills that are difficult to retain”.

Meanwhile, staff in the new workforce training and education directorate at a national and regional level are also included, including those transferring from Health Education England, with the exception of educators.

The scheme, which runs until 8 February, will not be open to all its employees, however.

Last July, NHSE announced 6,000 posts were set to be cut after staff from HEE, NHSD and NHSX transferred into the organisation amid a major reorganisation.

HSJ then revealed all staff would “know their future” by September 2023.

Rocky start

Trust mergers are always hotly debated in NHS leadership circles. The benefits around economies of scale and service reconfiguration are obvious, but critics often wield a long list of examples where the reality has failed to match up to the theory.

To that list, they will add Liverpool University Hospitals, created via the merger of Royal Liverpool and Aintree hospitals in 2019, which has seemed to struggle with multiple high-profile issues ever since.

One of the merger’s main proponents, Neil Goodwin, the former chair of Aintree who is now retired and lives in Scotland, reflected on this in an interview with HSJ, saying the problem was in the implementation.

He said: “With the passage of time, it tells me that perhaps the post-merger foundations weren’t put in place carefully enough.

“In practical terms, there’s been insufficient leadership from the new organisation from day one, without enough attention on bedding in the merger, setting the tone and style of working with clinicians to push through the changes that need to take place. The churn at board level has undoubtedly been a major contributor.”

It’s still surely too early to call the merger a failure – it may yet bring huge benefits in the longer term. But it’s certainly been a bad start.

Also on today

NHSE must encourage those with dental expertise to join local systems so that institutional knowledge and experience are not lost when commissioning responsibilities are transferred, writes Matthew Taylor in a comment piece. And in The Integrator, Dave West explains why contrary to what you might think, health and social care secretary Steve Barclay is not out to get integrated care systems.