NHS England changed

David49

NHS England employs over 15000 administrators, cuts on that scale are so similar to Musks “taking a chainsaw”to jobs, is Starmer taking a page out of Trumps playbook

I can't see how you can compare the two. The political implications tied to Starmer and Trump are fundamentally different.

Musk is unelected and Trump does not, democratically, have the power to do what he is doing. There are already many court cases taking place in America because of the lawbreaking.

Starmer has put this before parliament and is not overstepping the powers he has as PM.

Are you just inclined to ignore democracy and a countries laws, perhaps?

ronib

Of course there’s been a population increase since 2010 of around 5 million people so it’s hardly surprising that the NHS is under strain is one thought.
Given that Labour has struggled to renovate the previous government’s list of hospitals, (as did that government ) it is right that duplication is removed from its administration.

An increase in population can be a contributing factor to the pressures on the NHS, but it's just one of many influences.

For example both the aging population and overall population growth contribute to pressures on the NHS, but they do so in different ways. The aging population needs more intensive and specialised services, whereas overall growth increases the demand for a wider range of services across all demographics. And then, of course, we had Covid.

Picking one area that suits your bias does not make for discussion.

A explainer

What does it do, and why is it being scrapped?

What has the government announced?
NHS England, the body that has run the NHS in England since 2013, is being abolished. It is being merged with the Department of Health and Social Care (DHSC), which is run by Wes Streeting, the health secretary.
Keir Starmer announced the shock move yesterday in his speech on reforming the state.
“Today we are abolishing the biggest quango in the world,” Streeting said. He meant NHS England, which has 15,000 staff. However, the NHS as a whole employs about 1.5 million people, mainly through the 220 different health trusts, and is one of the world’s biggest organisations.
What did the prime minister say?
He portrayed it as a cost-saving and bureaucracy-slashing exercise which would put ministers back in charge of it and help patients. “I don’t see why decisions about £200bn of taxpayer money on something as fundamental to our security as the NHS should be taken by an arm’s-length body, NHS England”, he said. “And I can’t, in all honesty, explain to the British people why they should spend their money on two layers of bureaucracy [NHS England and the Department of Health and Social Care].”
What did Starmer mean by ‘two layers of bureaucracy?’
NHS England was created in 2013, when it was initially called the NHS Commissioning Board. Since then, it and the DHSC have contained many teams of officials who each do much the same thing. For example, each has a dedicated team covering GP services, mental health and urgent and emergency care (A&E and ambulance services). In his speech, the PM cited these examples of duplication in the course of justifying this massive shake-up of the NHS.
What does NHS England do?
Its key role was to commission clinical commissioning groups – local NHS bodies, which replaced primary care trusts – to provide the range of clinical services needed in their areas, such as GP care.
It directs, manages and oversees the whole of the health service in England. It is responsible for ensuring that the NHS’s key waiting times, such as the supposed maximum four-hour wait for A&E care and the 18-week wait for hospital treatment, are delivered.
What will happen to NHS England’s 13,000 staff?
Those who do not survive the brutal slimming-down of the organisation will be made redundant while the others will start working for the DHSC.
Amanda Pritchard, the outgoing chief executive at NHS England, told staff in an email on Monday that as a direct result of the DHSC’s decision to change its relationship with the NHS, the size of “the centre” – the headquarters of NHS England/DHSC in London – “could … decrease by around half”. NHS England staff working for its 42 regional integrated care boards – regional bodies that oversee NHS trusts – were also told that half of them were losing their jobs.
What changes are being made to the leadership of NHS England?
Pritchard announced on 25 February that she would be leaving at the end of this month.
Most of the organisation’s most senior executives have said since that they too will stand down at the same time.

Guardian - today

PoliticsNerd

ronib

Of course there’s been a population increase since 2010 of around 5 million people so it’s hardly surprising that the NHS is under strain is one thought.
Given that Labour has struggled to renovate the previous government’s list of hospitals, (as did that government ) it is right that duplication is removed from its administration.

An increase in population can be a contributing factor to the pressures on the NHS, but it's just one of many influences.

For example both the aging population and overall population growth contribute to pressures on the NHS, but they do so in different ways. The aging population needs more intensive and specialised services, whereas overall growth increases the demand for a wider range of services across all demographics. And then, of course, we had Covid.

Picking one area that suits your bias does not make for discussion.

Those issues would also make very little difference to the functioning of NHS England, which operates at a policy/advisory/executive level, and does not have operational functions.

Thank you Whitewavemark2 as always you are a great supplier of information.

I believe that Heath Secretary Andrew Lansley instigated the NHS England quango in 2013 as a means of introducing another layer of bureaucracy to 'improve' NHS spending.

My neighbour works for NHS England. He started his NHS life as a mental health nurse, so presumably if his job goes he can find employment in mental health. I hope so, he has a young family - 2 dear little boys.

The redundancy bill will be enormous - and I’m not so sure they will all find it easy to get jobs. Employers are cutting back because of increased costs, and some will face the usual age discrimination. This will add to the benefits bill. It will be some time before true financial savings can be ascertained.

Those issues would also make very little difference to the functioning of NHS England, which operates at a policy/advisory/executive level, and does not have operational functions.

It was a reply to Ronib's post as quoted. I think you will find that was about the general strains on the NHS, and doesn't mention NHS England. I agree both went a little off topic, but that GN forums, isn't it?

Barleyfields

The redundancy bill will be enormous - and I’m not so sure they will all find it easy to get jobs. Employers are cutting back because of increased costs, and some will face the usual age discrimination. This will add to the benefits bill. It will be some time before true financial savings can be ascertained.

That’s not a reason not to make a change on this scale though, is it? Every major restructuring, whether public or private sector, comes at significant cost.

PoliticsNerd

^Those issues would also make very little difference to the functioning of NHS England, which operates at a policy/advisory/executive level, and does not have operational functions.^

It was a reply to Ronib's post as quoted. I think you will find that was about the general strains on the NHS, and doesn't mention NHS England. I agree both went a little off topic, but that GN forums, isn't it?

True - tangents are definitely a major feature.

I don’t quite get how an increase in population of 5 million people wouldn’t impact on waiting lists and waiting times in hospitals and difficulty seeing a gp. So the administration/government needed to factor that in. In fact, are there any signs that it has?

Whitewavemark2

My neighbour works for NHS England. He started his NHS life as a mental health nurse, so presumably if his job goes he can find employment in mental health. I hope so, he has a young family - 2 dear little boys.

The NHS has significant staffing shortages especially when recruiting and retaining healthcare professionals, so hopefully he can be redeployed. It will be a tough time for many but I have some hope that this area will already have had some work done on it.

Barleyfields

The redundancy bill will be enormous - and I’m not so sure they will all find it easy to get jobs. Employers are cutting back because of increased costs, and some will face the usual age discrimination. This will add to the benefits bill. It will be some time before true financial savings can be ascertained.

This is largely about efficiency, duplication and the push towards reaching the government targets by 2029.

Many of the staff were drawn from the NHS as skilled workers - see my post about my neighbour and many will almost certainly absorbed back into theNHS.

I don’t think it will be so impactful as you are suggesting.

And even if it was, it would be the right thing to do.

ronib

I don’t quite get how an increase in population of 5 million people wouldn’t impact on waiting lists and waiting times in hospitals and difficulty seeing a gp. So the administration/government needed to factor that in. In fact, are there any signs that it has?

There have been an extra 2 million appointments appointments and waiting lists have been cut by 193,000 since July.

Wasn’t the waiting list quoted at 7 million so not much fun for the other 6,800,000 approx is it?

ronib

I don’t quite get how an increase in population of 5 million people wouldn’t impact on waiting lists and waiting times in hospitals and difficulty seeing a gp. So the administration/government needed to factor that in. In fact, are there any signs that it has?

Are there any signs it hasn't?

You asked if there were signs and there they are. Heading in the right direction. After 14 years of grinding the service into the ground progress was never going to be instant.

PoliticsNerd

Whitewavemark2

My neighbour works for NHS England. He started his NHS life as a mental health nurse, so presumably if his job goes he can find employment in mental health. I hope so, he has a young family - 2 dear little boys.

The NHS has significant staffing shortages especially when recruiting and retaining healthcare professionals, so hopefully he can be redeployed. It will be a tough time for many but I have some hope that this area will already have had some work done on it.

The shortages/vacancies in MH for people with his qualifications are huge!

Yes Wyllow3 look at numbers of new hospitals and urgent repairs not happening. Where are the 6,800,000 patients going to be treated and by whom?

Iam64

It’s nothing like taking a leaf out of trump’s plsybook. It’s exactly what we hoped for from Starmer’s government . Confident positive brave long term plans

It was a tongue in cheek comment, but if Starmer is going to do that to all the other Quangos it sounds good to me. OFWAT should be a prime target they have done a useless job of regulating water.

I have long held the opinion that there is far too many managers in the NHS across all services.

Do you not see these changes as the first stage in sorting the whole muddle out Ronib.

For years people have been saying there are too many managers, money being wasted, that no Government is brave enough to look at the NHS from the core out and start again.

This looks like the start of all of that happening and, until it is has been done, the whole system cannot be put right.

You seem to be expecting instant miracles.

A small part of the governments information

As promised in the manifesto, the government’s immediate priority has been to get a grip on record waiting lists.

To put us on track to reducing waiting times for elective care, the 2024 Autumn Budget provided funding to support the NHS to deliver the first step of an extra 2 million NHS operations, scans, and appointments a year in England, equivalent to 40,000 additional appointments a week.

Our milestone for change is ambitious, requiring a significant reduction in waiting list times with challenging public finances. For this reason, investment alone is not the answer: we will only deliver our milestone by reforming elective care. Working with the NHS, our next steps will:

Transform how elective care is delivered, improving productivity, and the way in which patients receive care, including more direct and timely diagnostic test referrals and results, increasing the availability of testing in communities and neighbourhoods. The capital investment provided in Autumn Budget 2024 will fund new surgical hubs and diagnostic scanners to build capacity.
Transform patients’ experience of care, by embracing technology. Care will be centred around patients’ lives and choices, as opposed to being inflexible and outdated. We will transform the NHS app, giving users the information they need to navigate and take control over their care.
Transform the model of care to make it more sustainable. There will be an increased focus on prevention throughout a patient’s care journey, dealing with issues earlier when they are easier to treat or cure. Siloed models of care will be reformed to improve patient experience and outcomes.

Referral processes will be effective and informed, with GPs having easier access to specialist clinical advice, and the priority will be to provide the right care, in the right place, at the right time, which may not be in a hospital setting.