The NHS Temperature Test

It’s been a few weeks since the White Paper was published. There was nothing in it that was a surprise to those of us working in the NHS and reading the trade journals. I recently reflected upon my conversations following its publication and as a result, I decided to do a totally unscientific survey on how staff in the NHS were currently feeling about job security.

My methodology? The NHS is a glorious institution: if you don’t work in the NHS, you know a family member or friend who does. It is through these loose social networks that I have been undertaking my research. I have traveled to the South Coast, to the heart of Berkshire, 100 miles north of the M25 and of course, central London.  I have also undertaken a literature search by keeping an eye on what’s being said in the Health Service Journal (who have run articles about redundancy every week for the last 3 weeks).

My conclusion is that staff are falling into four  key themes:

  1. Many staff are already working in an organisation that is facing significant financial pressure, and where major organisational change was already on the agenda.  Those staff working in acute Trusts mainly fall under this category
  2. Staff with significant service are taking the pragmatic approach that at least they have a substantial redundancy package to fall back upon.  The HSJ has run an article every week for the last 3 weeks preparing managers for this.
  3. Senior staff within PCTs (both clinicians and managers) recognise their value and the fact that many of the new GP consortia will require their skills.  They see the long-term position of job stability, just with a change of employer.
  4. Junior staff are showing higher levels of anxiety, as they are less clear about the future plans and how it relates to them.  This is understandable

There is one particular anecdote from my survey that I wish to share which highlights some of the above points:  Jane (fictional name) is the Head of Pharmacy in a PCT.  Since university she has worked her way up through the hospital system.  When she reached a glass ceiling, she moved into her local PCT.  In the last three years she has saved the PCT millions in reducing the drugs budget and she knows there is potential for more.  But with the White Paper she won’t be given the chance to see this through.

Jane has achieved her savings through working with the GPs.  She knows the different personalities, and how some are more progressive and forward-thinking than others.   Because of this first-hand experience, she knows how difficult it’s going to be to drive efficiencies into the drug budget for her patch when it’s devolved to the different GP consortiums.

The GPs need her expertise, and so Jane knows she’ll get a new a job working in one of the consortia.  She also has great belief in her abilities.  And in the back of her mind, Jane is aware that if it all goes wrong she has 15 years service and that equates to a substantial redundancy package.

Today, Jane continues to work hard, and like all NHS employees, as she wakes up every day knowing that she wants to deliver the best possible healthcare she can for her patients.

There is anger and fear about the proposals, but’s the subject of a different post in the future.