Clinical commissioning groups that choose to appoint staff from outside the NHS, adding to redundancy costs, should be prepared to publicly justify their decisions, the NHS Commissioning Board has said.

HR guidance from the board says CCGs should keep redundancy costs low and in the first instance look to fill jobs from existing NHS staff. It also tells CCGs to get legal advice for each potential staff transfer they intend to make.

The document says: “It is important that CCGs recognise there is no separate budget for redundancy costs, and therefore they will need to demonstrate they have taken all steps to minimise these costs and secure talent from existing NHS staff in the first instance.

“CCGs will need to be able to justify this decision in public, particularly if it leads to an increase in redundancy costs, as these are funded from the overall budget for the NHS.”

Jon Restell, chief executive of Managers in Partnership, which was consulted on the document, said the guidance could dissuade many CCGs from trying to do things differently.

He added: “The rhetoric around the creation of CCGs has, for too long, been about people having a blank cheque. At the end of the day there are financial constraints in the system and how many redundancies you can afford to bear.”

Mr Restell said staff wanted more honesty about the transition process, saying: “At the moment we are still talking about re-arranging the deckchairs when what we know is a reality is what will be a significant reduction in the number of staff doing this work.”

Shane Gordon, shadow accountable officer for North East Essex CCG and NHS Alliance senior member, said: “It’s important for CCGs to realise they operate within the constraints of the NHS as a public sector employer. The perception may have been that CCGs would have a completely free rein but that was probably an unrealistic starting point.”

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