The NHS Commissioning Board is likely to delay some management cuts until 2013-14 and take on interim staff under emergency measures sparked by delays in the transition to new NHS structures.
The body has acknowledged it is unlikely to appoint to all of its posts as planned and may not have all staff in place by the time it takes on its full statutory responsibilities in April.
A paper due to be considered by its board today sets out contingency measures in response to the delays. Its national human resources director Jo-Anne Wass told HSJ she hoped these measures could be kept to a minimum, but acknowledged they were likely to be used to some extent.
The first measure is that instead of appointing staff to roles within the new structures, those currently carrying out particular functions - or on particular pay grades - will instead be transferred en masse to the commissioning board. The process is described as “lift and shift”.
As the new structures are meant to have fewer posts, that would mean in some functions there would be more people initially employed by the board than it could afford in the long term. Therefore further rounds of redundancies during 2013-14 may be necessary.
The second measure is that if posts are unfilled interim managers could be hired to fulfil tasks.
Ms Wass admitted to HSJ it was “most likely” some staff would be lifted and shifted by function - although the board is considering using a mix of block transfers and interim appointments.
It has already confirmed that family health service staff - who commission primary care services - and National Patient Safety Agency staff will be lifted and shifted.
A paper to today’s board meeting details difficulties with the lift and shift approach, including the additional cost of “greater numbers of staff joining the commissioning board” and that it would “necessitate rationalisation in 2013-14”.
Ms Wass said it was not yet clear how widely the practice would be used, and added that she was confident the costs of any redundancies in 2013-14 could be met via a combination of the board’s running cost budget and a one-off allocation of £108m it is expecting to receive from the Department of Health in 2013-14.
In the commissioning board’s risk register for this month, the possibility it will fail to fully populate its organisational structure by March is rated red, even after mitigation actions are taken.
Delays to the board finalising its organisational structure are cited as a key reason for the board falling behind on recruitment. The final structure was only signed off by chief executive Sir David Nicholson last month.
Ms Wass said her greatest concern was about filling posts in the operations directorate due to its complexity. The directorate will account for about two thirds of the board’s planned 3,500 staff, including regional offices and local area teams.
The approach to lift and shift could vary in different regions, Ms Wass said. She added that temporary staff would be brought in where it was “critical” the role was filled on 1 April.
“Some roles we might be able to leave vacant,” she added, as most organisations do not have all their roles filled all the time.
Managers in Partnership chief executive Jon Restell said: “It is better to lift and shift than rush a process and make lots of mistakes and risk treating people unfairly.”
He said that where more people were being transferred than would be needed in the new system, this would create “conditions of ongoing uncertainty” for staff. However, “you have to balance uncertainty with doing a proper job and a fair one”.
Mr Restell said he expected the areas where lift and shift would be needed were likely to be identified by mid-October.
Recruitment data released by the NHS Commissioning Board shows that its appointees so far are disproportionately likely to be white, male, heterosexual and aged under 50.
A paper to today’s board meeting shows that 97.1 per cent of staff appointed in open competition to the body by 30 July were classified as “white British” - even though that group only accounted for 84 per cent of applicants.
People aged in their 50s accounted for 48.3 per cent of candidates, but only 34.3 per cent of those who had been hired. Fifty-seven per cent of appointees were aged in their 40s - compared with 40.1 per cent who applied for jobs.
Heterosexual appointees accounted for 94.3 per cent of the total against 84.8 per cent of those who applied. Successful applicants were also more likely to be Christian or Jewish, and less likely to be Muslim, Hindu or “other”.
Only on disability did the board have a positive story to tell. Just 0.4 per cent of candidates had a disability, compared with 2.9 per cent of staff appointed.
Lord Adebowale, a non-executive director of the board who raised concerns about the impact of the transition on equality at its previous board meeting, told HSJ large organisational upheavals tended to favour white, middle-aged men.
Jo-Anne Wass said she believed performance would improve as further appointments are made.
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