HSJ research reveals for the first time the extent of the brain drain caused in the past year by paying off primary care trust managers - half of whom were either clinicians or experts in commissioning and finance.

Commissioning brain drain ‘stripping assets’

Commissioning brain drain ‘stripping assets’

Despite the loss of skilled staff, with more than a quarter of those leaving having more than 15 years’ experience, the figures suggest the departures have not freed up as much cash to pay for clinical commissioning groups as had been hoped.

£18,196 - Average PCT MARS payout in 2010-11

£19,552 - Average PCT redundancy payout so far in 2011-12

Freedom of information responses from 57 PCTs reveal just over a fifth (21 per cent) of those who left under the mutually agreed resignation scheme - which handed staff who volunteered to leave up to a year’s salary - were clinicians.

Overall, 17 per cent of the 641 MARS leavers worked in commissioning, 6 per cent in finance and 10 per cent in public health.

More than a fifth (21 per cent) worked in the most senior roles, in Agenda for Change band 8 and above.

Taken together with the 776 non-MARS redundancies that the FOI responses revealed had taken place in the 57 PCTs since the start of 2010-11, 28 per cent of leavers had clocked up more than 15 years in the health service.

King’s Fund chief executive Chris Ham warned the NHS was “asset stripping the commissioning function, removing the very people and skills it needs to retain”.

There was a “serious risk” that the lost expertise would result in the NHS losing financial control, he said.

Managers in Partnership chief executive Jon Restell said the management cuts “haven’t been done with the future needs of the NHS in mind”.

“These figures suggest very experienced people are walking out the door who have spent years building relationships with key players locally,” he added.

HSJ has also obtained figures from the Department of Health setting out each region’s spending on MARS payments and its expected savings. These show annual recurrent savings vary from just £817,000 in the North East to £20.1m in the North West, amounting to £75.2m nationally.

The 2010-11 operating framework said CCGs would be given £2 per head to “support them in the development of their consortia [CCGs]”, which would be “resourced primarily from management cost savings realised from the MARS scheme”.

But NHS Information Centre figures on GP-registered populations suggest the shortfall will be around £27.9m. Some PCTs and clusters are supplementing MARS savings with other funds to pay for CCG start-up costs. HSJ understands some are doing this by simply accelerating their management cut targets.

British Medical Association GPs committee deputy chair Richard Vautrey said: “There are big questions about whether CCGs will have the necessary resource to be able to support the staff they require.

“Some PCTs have been supportive and proactive but others have been very reluctant to give them the personnel or resources.”

He also expressed concern at the calibre of managers leaving the NHS. “The huge experience these people have got, it takes years to replace,” he said.

The findings confirm fears of a “brain drain”, raised in HSJ’s biggest ever survey of readers last year. It showed a disproportionate number of managers considering leaving the NHS were senior leaders or had highly valued skills.

PCT managers who have left received an average payout of £18,196 through MARS, or £19,552 through redundancy, according to the FOI requests.

Dr Vautrey, Mr Restell and Professor Ham all said managers needed greater certainty to avoid a further talent drain.

NHS East of England chief executive Sir Neil McKay,

who is responsible nationally for staff’s transition to the new system, told HSJ he hoped the decisions to cluster strategic health authorities and retain them until 2013 had increased stability.

He said: “We can see there are going to be quite a lot of opportunities for people in PCTs to move into the new world. It’s important for people to feel confident in their own abilities and take control of their destiny.”

However, the retention and exit terms scheme (RETS) under which “mission critical” staff were offered a two year job guarantee and, in some cases, extra pay, could need to be revised in light of SHAs’ extended lifetime, meaning fewer people would be eligible, he said.