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Huge increase in staff at DHSC and NHS England

Published on: 19 Oct 2021

The Department of Health and Social Care has more than doubled its staff over the past 18 months, alongside large increases at NHS England and Public Health England.

It comes as government has commissioned a review of local NHS leadership and efficiency and warned that it will “rigorously hold [the NHS] to account for the money it has been given”.

The DHSC said the increase was needed to respond to covid and to oversee government priorities such as its Health and Care Bill.

Analysis of routine workforce data published by the DHSC shows:

  • The number of full-time equivalent payroll staff at the DHSC, excluding its agencies/arm’s length bodies, increased by 131 per cent between January 2020 and July 2021. It has continued to increase since July 2020 – after the first wave of covid – and since January this year, which was the peak of the winter wave.
  • This included a 114 per cent increase in “senior civil service” grades – which include permanent secretaries, director generals, directors and deputy directors – between January 2020 and July 2021.
  • The number of payroll staff at Public Health England also steeply increased up to July 2021, which are the most recent figures available. Most PHE staff have since then transferred to new DHSC agencies, the UK Health Security Agency and the Office for Health Improvement and Disparities, when it was abolished at the end of September.
  • Payroll staff at NHS England and Improvement (including their regional and local offices) have increased by 27 per cent between January 2020 and July 2021, including a 56 per cent increase in staff at senior (equivalent of senior civil service) grades, according to the DHSC workforce figures.
  • In NHS providers and clinical commissioning groups, between January 2020 and June 2021 (the latest figures available), there was a 5.9 per cent increase in total full-time equivalent staff, and a 7.8 per cent increase in senior managers.

Earlier this month the health and social care secretary Sajid Javid announced a review of health and social care leadership and management, with an emphasis on efficiency, after the government introduced a new levy to pay for an increase in revenue funding to the sectors for coming years. 

A senior government source was quoted by The Times as saying: “Patients need to see tangible results and waiting times coming down. The [DHSC] cannot simply be a cheerleader for the NHS. It needs to rigorously hold it to account for the money it has been given.”

The DHSC said that as of July, 28.7 per cent of its full-time equivalent staff were working on Test and Trace. It pointed out that the pandemic was ongoing and that other new DHSC priorities include social care reform, hospital building, the Health and Care Bill, and NHS recruitment.

A DHSC spokesperson said: “In the face of the biggest public health crisis in a century it is right that we have the resource needed to tackle the pandemic and save lives.

“The public expects government to do all it can in the face of a global threat. We have rolled out the largest vaccination programme the UK has ever seen, and put in place a testing network that processes hundreds of thousands of tests a day, all while pushing forward with vital health and social care reforms. To do so without the staff we need to deliver it would be a dereliction of duty.”