Foundation trusts threaten job losses, abolition of bonuses and daytime working hours that end at 10pm
NHS staff are facing compulsory redundancies, consultants the loss of bonuses and district hospitals severely reduced funding, according a leaked health service document proposing savings to negotiate the economic downturn.
The internal briefing paper circulated by the NHS foundation trust network (FTN) calls for wide-ranging reform of national wage scales, an end to guaranteed employment for trainees and a cap on pensions for those earning more than £100,000 a year.
Such radical cost-cutting – being discussed by senior managers as part of the reconfiguration of the health service to deliver more community services – threatens to undermine the NHS employment guarantee proposed last month by the health secretary, Andy Burnham.
The document, obtained by health service union Unison, has emerged on the day employers and staff are due to meet in the NHS social partnership forum to discuss the possibility of offering greater flexibility in working practices in return for protecting jobs. The leak signals growing union unease as the financial squeeze tightens.
In December, Burnham promised to explore with the unions the possibility of “whether we could offer frontline staff an employment guarantee locally or regionally in return for flexibility, mobility and sustained pay restraint”.
The briefing suggests that semi-autonomous NHS organisations are anticipating a more severe squeeze on resources than the government has publicly conceded and are beginning to act to protect budgets before the general election.
On the overall financial situation, the paper says: “There is now widespread recognition that … with no third-year commitment from Treasury to even flat cash the situation could get worse than currently predicted.”
Redistribution of resources to community services, it suggests, will take “30-40% of activity out of the secondary sector (district general hospitals)”. On redundancies, the FTN says: “Foundation trusts do not believe that, in the economic climate and given the system and reconfiguration challenges they are facing, it will be possible to offer any guarantees that compulsory redundancies will not be required.”
It adds that all foundation trusts will want to “support staff to find suitable alternative employment in partnership with the local health economy”.
The document, circulated by Sue Slipman, director of the foundation trust network, invites comment from chief executives and human resources directors. A covering email says the document includes “the policy changes we need the Department of Health to manage nationally to ensure the level of flexibility in the workforce” required to face the coming “financial and service reconfiguration challenges”.
Among changes urged are:
• Abolition of “clinical excellence awards” (merit payments or bonuses for consultants).
• Freezing incremental pay progression for 2/3 years.
• Reducing the number of pay bands.
• Reform of sick pay.
• Extending daytime working hours to 10pm.
The above reforms are described as “Red Line” priorities. Other savings urged on the DoH include an end to job guarantees for NHS trainees, capping pensions for high earners over £100,000 and removal of London weightings from pension rights.
Mike Jackson, the senior national officer for health at Unison, said the trust network had “torpedoed discussions that were due to take place this afternoon by saying it won’t be possible to offer an employment guarantee.
“Andy Burnham had put the proposal to us. We would prefer to see existing staff trained and transferred across to primary care services.
“I find it a bizarre way to deal with the challenges facing the NHS. They want to extend day working from 8pm to 10pm. We only recently agreed the payments for working anti-social hours.
“They say they want to reduce incentivised pay, but they need that to get staff. They propose taking out pay bands, but that would all cost money.”
There are 125 foundation trusts in the NHS; the first were created in 2004. About half the acute hospital trusts in the UK have been granted foundation status as a recognition of their medical and administrative success.
The foundation trust network said the document showed that “we are looking at options and asking people [in trusts] to talk around what are the priorities.”
From the Guardian – read the leaked document here