The practical implications of the “pause” in the passage of the Health Bill will significantly hamper the reform process, according to NHS sources.
Strategic health authority staff have been told the abolition of the organisations would be delayed by three months until July next year because of the pause, as will the establishment of the NHS Commissioning Board.
The government’s appointment of a chair of the commissioning board, and the chief executive of a new agency to oversee non-foundation provider trusts, will be delayed until after the pause – pushing them to June at the earliest.
Senior executive appointments to the board, which had been anticipated in May, are now also expected to be put back.
NHS chief executive and chief executive elect of the commissioning board Sir David Nicholson has told senior staff there will be other practical consequences of the pause, but said the NHS should press on with many of the planned reforms.
Senior NHS sources involved in the commissioning transition said the uncertainty would inevitably frustrate the development of both consortia and the commissioning board, and delay associated decisions about staff assignment, transfer and redundancy.
One source pointed to the possibility of the government deciding to significantly slow down or limit the handover of commissioning to GP led consortia.
The wait could also lead to either a larger commissioning board than previously envisaged, potentially with around 30 “outposts”, rather than the five or six so far considered more likely, or some primary care trust clusters remaining as an additional management tier.
DH guidance with early details of consortium authorisation requirements and governance, which had been anticipated in April, is now also likely to be postponed. A source said that if the April 2013 deadline for the abolition of PCTs remains, the pause will exacerbate an already tight development timetable.
One senior commissioning source said: “Just as we were starting to get somewhere [with the commissioning transition] it has all been thrown up in the air again.”
The change will also delay some redundancies and employment transfers. But Managers in Partnership chief executive Jon Restell said another “big concern” was that some people had already been made compulsorily redundant when they could have stayed on for at least another three months.
Chartered Institute of Personnel and Development senior public policy adviser Ben Willmott said it was unlikely organisations could retract redundancies.
It was probable that some managers would have to be re-employed in interim roles, despite this potentially costing the NHS more, he said.
Further guidance on the human resources implications of the reforms and the full impact of the pause were expected this week but had not been published as HSJ went to press.