‘Large numbers’ of staff to lose jobs

The Department of Health’s informatics directorate is safe from immediate change as is the job of its head, Christine Connelly.

However, the number of managerial staff across the NHS will decrease “significantly”, according to a letter from the NHS chief executive.

Sir David Nicholson has written to all NHS chief executives to set out how the massive reorganisation of the NHS outlined in this week’s white paper will be implemented.

In the letter he says “large numbers of people” working in primary care trusts, arm’s length bodies, strategic health authorities and the DH will be affected by the changes.

The white paper – ‘Equity and excellence: Liberating the NHS’ – will launch a top to bottom reorganisation of the NHS, that will include slimming down the DH, scrapping SHAs and PCTs and the devolution of a large part of the NHS budget to GP consortia.

The letter adds: “Numbers of managerial staff will decrease significantly. Staff may also experience change in who they work for and the nature of that work.”

The NHS chief executive goes on to say that he will ensure that “every member of staff in an SHA or PCT has the opportunity for a discussion with their line manager on the changes and how they may affect them as they develop."

All staff should have had an initial discussion with their line manager by the end of September. The letter says formal consultation with staff and their representatives will be handled locally.

Sir David tells chief executives that immediate steps need to be taken to split commissioner and provider functions at national and regional level. He says this work should be completed by the end of the year.

The letter announces that it will be led by two new appointments – Dame Barbara Hakin as managing director of commissioning development and Ian Dalton as managing director of provider development.

A “bridging function” at national level will be led by the NHS chief executive and SHAs will be made responsible for the initial steps in the transformation process in their regions.

The letter says there will be “no immediate changes” to other key functions including informatics and that existing director generals will continue to lead on their national policy framework.

The letter says any changes to their functions will be part of the next phase of transition.

On Monday, Sir David said an announcement on the future of the National Programme for IT in the NHS will be made in four weeks, with an information strategy to follow in the autumn.

In his letter, Sir David says the Quality, Innovation, Productivity and Prevention initiative will continue to be of central importance as the white paper is implemented.

Regional QIPP plans will become QIPP and Reform plans with current QIPP plans split between commissioner and provider requirements.

The 15 page letter adds that the NHS chief executive intends to strength central controls on quality, finance, operations and QIPP delivery while the new system is delivered.

At this year’s NHS Confederation conference in Liverpool, Sir David underlined his personal commitment to the NHS. He urged managers to lead the changes and to find the "energy" in the "values" of the NHS.

In line with this, his letter urges managers to exhibit “leadership behaviours” and to “avoid becoming commentators” on the coalition’s plans. He says they should look beyond self interest and see how opportunities can be maximised rather than simply mitigating risks.

He adds: “Your leadership behaviours will absolutely set the tone for the period we are now in and directly impact on our chances of success.”

The letter is the first in a series of communications that Sir David will send over coming months.