A succession of service redesigns across Greater Manchester has left staff fatigued and confused, according to the chief executive of one foundation trust.

Ann Barnes, chief executive of Stockport FT, said the latest reconfiguration, Healthier Together, had also pitched trusts across the conurbation into “direct competition” while those leading the redesign  endorsed a collaborative and “partnership” approach.

Manchester tram

A series of reviews and designations in Greater Manchester had been ‘incredibly confusing’ for staff, said Ann Barnes

In a talk about the local politics of service redesign at the Foundation Trust Network conference last week, Ms Barnes described the “provider world” as having moved from “dealing with competition to some extent to suddenly being thrown into an understanding of partnerships and collaboration”.

This required boards and staff to adapt to “very different working relationships” and adopt new “sets of tools”.

Staff at Stockport had been left “confused” and “fatigued” by several service redesigns in quick succession, she added.

Ms Barnes said the Healthier Together consultation had been preceded by a reconfiguration across the south of the city, which aimed to ensure that clinical and non-clinical services could be delivered in partnership.

This review was followed by the cross-Manchester Healthier Together consultation and then by the badging of south Manchester as a “challenged health economy” by the NHS Trust Development Authority, Monitor and NHS England.

Ms Barnes said this package of reviews and designations had been “incredibly confusing” for staff.

“One minute we’re talking about southern sector and they’re working together to come up with models of care,” she said. “Then we’re talking about Healthier Together with a slightly different set of specialties and very political, and then suddenly we’re talking about this new thing – challenged health economies.

“[Staff] wanted to know why we were a challenged health economy any more than any other health economy.”

Consultants and managers were suffering a “bit of fatigue of change”, Ms Barnes added.

“There’s scepticism of ‘well, will this one make the difference?’ And there’s a clash with the day to day priorities they’ve got.”

Decisions taken by health agency officials had led to even more of “a disconnect with our staff, our senior managers and with our consultants”, she added.

“That was quite difficult in terms of trying to communicate to let them know what was happening whilst we were frantically having meetings almost every evening.”

The challenge for Stockport was to “create – and tell – what needs to be a clearer, simpler story for our staff”, she said.

“It needs to somehow weave together the improved patient care for Stockport in with the concept of partnership fundamentally both within and outside of Stockport.”