Employment from the government's radical restructuring of the NHS is at least twice as large as previous ideas, and other parts of health services have also diminished.
The staff shaking caused by the abolition of NHS England and unprecedented cost reductions means the number of lost posts will skyrocket from the expected 10,000 to 20,000-30,000.
Many people working in the 42 Integrated Care Boards (ICBs) of the UK's NHS can see 10,000 people working in the NHS England and the Department of Health and Social Care (DHSC) that have already acquired their roles. ICBS, the community health services agency, which oversees the NHS Trust group, employs 25,000 people between them.
Sir Jim McKee, new director of NHS England, has directed ICBS to cut running costs by 50% by the end of the year. “If you consider that the ICB employs 25,000 people, that means half of them will go,” said a senior NHS official. This could result in the loss of 12,500 posts.
Additionally, MacKey has ordered the 220 NHS Trust, which provides care across England to reduce the number of people working in corporate services such as HR, finance and communications. That could lead to thousands of officials losing their jobs, insiders say.
Mackey handed the harsh news to ICB and trusted leaders this week over calls and meetings. He outlined the need for the NHS to implement large-scale budget cuts as part of a “reset” of services' finances, helping to avoid overexpenditures from 2025-26.
Mackey, who took over Amanda Pritchard on April 1, but already has made important decisions about the future of the NHS, said the outlook for such a massive deficit “had scared the living daylight” from government ministers, reported by the Health Services Journal (HSJ).
Advanced ICB operators say it will be impossible to take on the full scope of their activities, including fundraising vaccination programs, providing blood pressure checks and improving dental health for children, to cut running costs by half. ICB recently cut budget cuts by 20% as part of the round before cost reductions.
“Operationally, this can be a disaster. 50% is huge in addition to what some ICBs already do. ICB officials said:
“In ICB, there is no more “fat” to trim. If implemented in the blanket way, it is very difficult to see how this doesn't lead to reduced services. ”
Julian Kelly, the retired assistant chief executive of NHS England, told the Commons Public Accounts Committee on Thursday that it was part of a broad restructuring of NHS England, where ICB staff has been cut in half.
Kelly scrutinised government spending and told the Cross-Party Committee that if a 50% reduction in staffing in the NHS England would save £400 million a year, if the unemployment programme was completed, it would save £750 million a year. He didn't show how many posts he could make.
The scale of budget cuts that Mackey is pursuing has caused surprises across the NHS. One leader told HSJ that the scale and speed of the reduction in ICB running costs is “terrifying” and causes disruption to services.
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Loss of so many experienced staff can threaten both the willingness to service to improve waiting times for treatment, and the street plan to overhaul how it works through “three big shifts.” The Minister is warned by Matthew Taylor, the boss of the NHS Union and former head of the Downing Street Policy Unit under Tony Blair.
“NHS staff are digesting the news that NHS England will no longer exist in two years. But the bigger problem is that it will be reduced by 50% not only to the central capacity but also to the system. [ICBs] Taylor told the Guardian.
“Along with thousands of redundancy, the danger is that the scale of change and anxiety will divert organizations from the difficult task of achieving recovery and reform in the context of unprecedented financial pressure.”
Matt Barrow, a national officer at FDA Union, who represents many of the DHSC staff, said:
“Of course, the ministers have a democratic right to determine the size of the nation, but without results, we cannot reduce this size. If you are cutting staff, there are not enough people to do the same amount of work, so the ministers have to decide what they want to do.”
