Hundreds of NHS management posts look set to disappear this April as more than 20 trust mergers take effect. Figures provided by trusts suggest the latest round of reorganisation could save the NHS up to £20m a year.
Despite the scale of reorganisation - which involves 49 trusts in England alone - managers predict there will be very few job losses. Most say they have been filling board level vacancies with short-term appointees.
But the First Division Association, which represents many NHS managers at board level, said it had been asked for help by between 70 and 100 of its members caught in the restructuring.
FDA national officer Jon Restell said: 'We have been taking very urgent legal advice on their situation. The problem is that, because of the timescale of these mergers, many people will not know by 1 April whether or not they have a job on the new board, and may not know for possibly six months after that.
'They have the choice of taking redundancy at that point or accepting short-term project work which may or may not lead to a job. The difficulty is that, unless they opt for redundancy within a fortnight, they may lose their right to claim.'
This year's mergers follow a 22-strong programme which took effect on 1 April 1998. Mr Restell said that round had been 'generally well managed' but he was concerned about what would happen this year. An HSJ survey of those affected this year found predicted management-cost savings ranging from just£275,000 to as much as£1.5m a year - though many trusts predict much of the money will not be seen until year three.
Total savings from the 17 sets of mergers which provided figures amount to a predicted£12m annual savings - almost all of which will come from the wages bill for executive directors and their support staff. Four programmes were either unable to suggest a figure or failed to reply.
Most of those surveyed were reluctant to identify job losses among staff below board level, though many acknowledged there would be some once new structures were agreed - and that these should result in further savings.
At least three chief executives - Pru Lapworth at Fosse Health trust, Zilla Heffer at the Royal London Homoeopathic Hospital trust and Ann Windiate at Riverside Mental Health trust - know they will be out of a job.
The merger of west London's three mental health trusts will mean 30 job losses. Around 160 posts will be affected by the merger of three Suffolk community trusts, and the merger of Epsom Healthcare and St Helier trust will affect 40 or 50 posts.
See news focus, pages 10-11; comment, page 15.
Trust mergers and predicted annual savings
Riverside and Royal London Homoeopathic£275,000
West London mental health£1m
Northwick Park and Central Middlesex£500,000
St Helier and Epsom Health Care£1.5m
Lincoln and District and West Lindsey£400,000
Southport and west Lancashire£750,000
Trent ambulance services£2m over five years
Northumbria and Durham County£500,000
South Lincolnshire and Mulberry£500,000
East Kent up to£1m
Cornwall Healthcare and Trecare£400,000
Hartlepool and East Durham£500,000
Wellhouse and Chase Farm Hospital£500,000
Bedfordshire community trusts£510,000
South west London community£750,000