The fate of tens of thousands of NHS staff may become clearer during the next few weeks, with large redundancy bills still a risk for some organisations, HSJ has been told.
Primary care trust and strategic health authority staff are due to be sent letters on 31 January telling them the “expected destination (or destinations) of their current function” in the new system.
Information about how roles will be split – for example between clinical commissioning groups, commissioning support organisations, the NHS Commissioning Board and local authorities – was due to be distributed by the end of this month. The information was contained in a letter from NHS Midlands and East chief executive Sir Neil McKay, the national senior responsible officer for the HR transition, sent to chief executives at the end of 2011.
Several employers told HSJ that in many cases the “destination” will be unclear. One said it would be no more than an “indication” because, for example, it was not known how much CCGs would do themselves or what the shape and size of some commissioning support organisations would be.
Some common “expectations” are beginning to emerge for staff numbers in the future organisations, however.
Senior sources involved in developing commissioning support organisations said the Department of Health expected they could employ as few as 7,000-8,000 staff in total. CCGs are widely expected to employ an even smaller number.
Commissioners involved in developing the local “branches” of the commissioning board said each was expected to employ an average of 50-60 staff. That means around 2,750 across about 50 branches.
The branches’ remit is expected to be dominated by direct commissioning of specialist and primary care. However they will also have an “oversight” of CCGs, according to sources involved in discussions. The board as a whole is expected to employ 3,000-4,000 people.
Even allowing for another 7,500 or so PCT and SHA staff potentially moving to local authorities and Public Health England, the figures indicate there may still be significant further redundancies.
DH function mapping analysis seen by HSJ says at the end of September there were 33,288 PCT staff and 3,656 in SHAs.
Senior figures said there would still need to be large staff reductions in some regions, while some had already cut enough.
One PCT cluster chief executive warned that once new organisations and roles were outlined, the consequent redundancy fund which PCTs and SHAs might have to create could send them into deficit.
The source said: “There is a danger that if we know what the structures are going to be, we will then have an idea of which staff won’t be needed in the new system. As soon as we know that, we will have redundancy bills coming our way, and we will have to make provision in this year’s accounts.
“That could tip some down into deficit. The handling of this has to be really careful.”