Leak reveals systems planning to cut permanent staff

NHS organisations across two integrated care systems are planning a cut to their total substantive workforce this year, as part of plans to save money. 

According to a “high level” workforce plan for the Midlands, seen by HSJ, Black Country ICS and Nottingham and Nottinghamshire ICS are both planning to cut the number of permanently employed staff in the NHS in their area during 2024-25. 

Black Country ICS has put forward proposals to cut its substantive staff by 544 over the next year (1.4 per cent of the system’s total workforce) and Nottinghamshire by 70 (0.2 per cent). All other systems are planning to grow their substantive workforce.

The figures cover all NHS staff in the system, not only those employed in the integrated care boards. The plans don’t state which organisations will see the reductions but because provider trusts employ far more staff than the ICB, the biggest impact is likely to be on the providers.

As reported by HSJ earlier this month, Black Country and Nottinghamshire saw the largest growth in their total workforce over the last five years, and both systems also have large deficits. All health systems are facing increasing pressure from NHS England to constrain further workforce growth and, in some cases, are launching redundancy programmes to reduce headcounts, particularly among non-clinical staff. 

In a statement, Black Country ICS said: “NHS leaders have agreed enhanced vacancy and expenditure controls as part of the financial recovery plan. These include enhanced workforce controls, along with quality impact processes, to support a safe reduction in our headcount where appropriate.

“Given the growth in workforce over the last few years, savings will most likely be achieved through less temporary staffing/bank use and natural attrition.”

Nottingham and Nottinghamshire did not respond when asked for a comment.

The workforce modelling sets out plans for the total workforce, split into substantive staff and temporary staff (see image below). Overall, the Midlands region plans to decrease the total workforce by 1.2 per cent. Derbyshire ICS is the only system planning to grow its workforce, but by just 0.6 per cent or around 180 staff members.

There are steep targets set for reducing the number of temporary staff (bank and agency) across the Midlands, with plans to cut their number by 22 per cent. Leicester, Leicestershire and Rutland ICS has set out temporary staffing cuts of 40 per cent, in contrast to Coventry and Warwickshire, which plans to cut them by 8 per cent.

Combining both, Lincolnshire has the tightest plan, expecting to hold its total workforce flat. 

According to figures from last year, trusts spent £3.5bn on temporary staff, after several years in which they managed to shrink these costs.