Managers face axe at under-pressure trust

A trust grappling with an “inadequate” rating at its high-profile high secure hospital has begun a major management restructure expected to include redundancies, HSJ has learned.

Nottinghamshire Healthcare Foundation Trust announced it was beginning a “mutually agreed resignation scheme” — similar to voluntary redundancy — for clinical and non-clinical managers at band 8a and higher, which will run through January. 

However, HSJ understands the restructure may later result in redundancies. 

The plans cover most senior management of three of the trust’s main “care groups” — for general mental health, community health, and forensic services — but details of changes to posts haven’t yet been finalised, HSJ understands. 

Reasons given to staff for the changes include wanting to grow clinical leadership and to simplify structures.

However, finances may also be a factor, according to sources at the trust.

This month’s board papers say its finances are a “considerable concern”, and halfway through 2023-24 reported a £16.8m deficit, £12.8m worse than planned.

The trust is also grappling with major care quality challenges, as Rampton Hospital – one of England’s three highly secure hospitals – was this week returned to an “inadequate” by the Care Quality Commission, after a brief spell as “requires improvement”.

The restructure plan so far involves operational managers at Agenda for Change band 8a and above, while business support and administrative roles are still being considered. 

The FT’s director of people and culture Jen Guiver told HSJ in a statement: “On Monday 15 January, the trust announced to colleagues that it is launching a mutually agreed resignation scheme. It is really important to be clear that MARS is not a redundancy or a voluntary redundancy scheme and the terms under which applicants resign are very different.”

She said the trust had “no plans for redundancies at this time, in fact we continue to recruit to positions across the trust”.

She added: “We are simply using MARS to provide some flexibility as we begin to address the need for large-scale transformational change in the way we deliver care to our patients. This transformation is needed so that we can provide the very best care to our patients into the future.

“We hope the scheme will increase flexibility in the workforce to support transformation. As MARS is a voluntary resignation scheme, we have no expectations as to how many colleagues will apply for the opportunity and it’s important to remember that each application will be assessed to ensure any risks are mitigated.”