Thoughts on NHS Restructure – Part 2

Restructure.  That’s the reality of the NHS at at present.  This is my second post about restructure within the NHS,  and highlights another issue that I regularly see when working with different NHS Trusts around the country.

When the finance guys look at the numbers and decide that there needs to be a plan to bring the balance sheet back into the black, the gut reaction is often to take a percentage cut from each division – 10%, 12%, 25% (sound familiar?).

But there are two reasons why this isn’t the best approach:

1. To enable effective organisational change that generates cost savings, resources need to be ploughed into the organisation.  In otherwords, Trusts need to “spend to save”.    In some services it is as simple as making an invest need to be able to realise any potential income generation.

Turning to HR:  By asking a HR Department to cut back on 25% of it’s employee relations team when it’s just about to embark on a major redundancy programme is just madness.

During any major downsizing – it’s all on hands-on-deck if you’re in HR.  There are numerous meetings, letters, calculations and other transactional tasks that need to be taken.  And that’s not even considering the transformational elements that should be part of the mix.

Trying to do this within limit resources means that the organisation is more likely to encounter problems down-stream. Problems that cost.  Either at Employment Tribunals or that fact that the organisational change wasn’t properly thought through and doesn’t work.

2. A flat cut across departments encourages silo working.    Organisations should consider what cost efficiencies can be gained by redesigning a workforce that cuts across the organisation.  Such as moving from a service that is  decentralised to a centralised approach.

When departments seek to achieve a percentage target, the organisation does not give itself the time and space to consider what greater, and perhaps more appropriate savings could be made within the system  as a whole.

There is often a pressing need to identify how money is going to be saved, yesterday.  Decisions are made under pressure, and the impact is that there are lost opportunities.

All the above is easy for me to say, as I’ve already learnt from my mistakes.   However, I am (un)fortunate enough to have already lived through this fight before in the last five years.  Not many of my colleagues have.

Significant savings require a radical, yet carefully planned and thoroughly considered  organisational change plan.  I know that I’m not stating anything new here.   I just felt it had to be said again.


2 comments on “Thoughts on NHS Restructure – Part 2

  1. anne.eccleston says:

    I wholeheartedly agree with Karen. I have had to work with organisations including the NHS where cost saving initiatives didnt work, left HR overworked and saw many colleagues working far too many hours and stress related absences, and the overall results either collapsing, or limping with services unable to deliver.

    There must always be the time to stop, think and digest before launching into acting.

  2. Rick says:

    Yes and you could do that organisational change and downsizing, achieving considerable savings, without completely restructuring the NHS at a cost of £3bn!

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