What's happening to NHS redundancies?

18 November 2011

After unprecedented increases in the number of staff over the past decade and a half – from 840,000 to 1 million – the NHS workforce in England is under considerable pressure. All NHS organisations, whether providing community, mental health or acute services, have to meet challenging productivity targets, and hospital budgets are also under pressure through reduced activity and lower real-terms tariff prices.

Added to this are government ambitions to cut management costs by 45 per cent by 2014, in part through the abolition of primary care trusts and strategic health authorities by 2012/13. It is clear that the size and structure of the NHS workforce – which accounts for about half of the total NHS spend each year – looks set to change.

The beginning of this change is perhaps evident from the latest compulsory redundancy figures, released by the Information Centre in October following a request from the Department of Health to review the accuracy of the figures. Since July 2010, when the coalition government released the NHS White Paper, the number of compulsory redundancies in the NHS in England has increased in three successive quarters.

The latest figures for quarter one 2011/12 show 214 compulsory redundancies of clinical staff (this includes all doctors and all qualified non-medical staff) and 1,242 compulsory redundancies of non-clinical staff (which includes unqualified clinical staff and support staff). The majority of these non-clinical redundancies are likely to be managerial roles in primary care trusts and strategic health authorities.

While these figures might seem small for a workforce of approximately 1 million, it should be noted that these are only compulsory redundancy figures and therefore do not include voluntary redundancies or posts that have been vacated and will not be filled.

With compulsory redundancy figures only available at a national level it is difficult to measure this data in any further detail. It would be particularly interesting to look at local variations and at any further factors contributing to changes in workforce numbers. The data cannot reveal whether the redundancies are the result of organisations cutting staff and services in response to financial pressures, or whether they are the result of genuine planned productivity improvements, where fewer staff are needed because a service has been improved by reviewing pathways or through the use of technology. 

While this data cannot distinguish between these two cases, the figures indicate one aspect of how the NHS is responding to the productivity challenge.  

Click on the graph below to expand

NHS redundancies headcount

Graph of NHS redundancies October 2011

Source: Monthly NHS Hospital and Community Health Service (HCHS) Workforce Statistics in England - July 2011, Provisional, Experimental Statistics

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