Revealed: ‘Tired’ NHS England staff will not know their fate until September

The reorganisation and rationalisation of NHS England will take place in three waves between February and June, HSJ has learned, with the organisation’s new structure not being confirmed until next autumn.

A leaked slide from an NHSE all-staff briefing, seen by HSJ, shows a timeline of the reorganisation. It runs from this month until September 2023. All staff will “know their future” by then, claims the slide.

NHSE is undergoing a major reorganisation driven by the need to take on the responsibilities of Health Education England and NHS Digital, and to cut at least 6,000 posts from the combined headcount.

NHSE’s divisions and directorates will be reorganised in three waves, according to the slide. They are: 

• Group one - February to mid-March: transformation directorate; workforce; regional (including workforce, improvement/assurance and oversight/analytics); vaccinations and screening.
• Group two - April to mid-May: nursing and medical; finance; final regional strategy; delivery; and commercial operations.
• Group three - late May to June: human resources and organisational development.

Late last month, former health and social care secretary Therese Coffey ordered NHS Digital’s merger with NHSE to be brought forward from March to January.

HSJ understands that, despite the difficulties this caused, NHSE decided not to return to the original timetable when Ms Coffey was reshuffled a few days later as it would only confuse and dismay staff further.

Therefore, NHSD staff will be consulted on their future between now and early January. This will align closely with the reorganisation of the NHSE transformation group, which has the greatest crossover with NHSD.

The consultation process for HEE staff will take place in February and March.

There are also plans to establish two “focused voluntary redundancy schemes” for affected staff. The first would run from January to March, and the second from April to June. However, these are subject to government approval.

The final implementation planning and delivery of the directorate or regional design is expected to take place next summer and conclude at the end of August.

A box below the timeline added: “As in all change processes, things may need to be adjusted. Groups are subject to change. We will aim to bring colleagues certainty sooner if design plans are ready ahead of schedule. We will look at ways we can bring these areas into an earlier group.”

‘We are all so tired’

Several comments made anonymously by NHSE staff during the presentation, and seen by HSJ, expressed weariness with the second major reorganisation in three years.

One comment, which received at least 216 “upvotes,” said: “We are all so tired, given that we went through a reorganisation just before covid and then worked in different ways through covid. September 2023 is a full four years from when we went through a reorganisation that never materialised.

“At what point will we have stability to focus on improvement and delivery, rather than worrying about losing our jobs and all that can bring?

“This is really impacting staff morale.”

Other comments asked for more clarity around the proposed new structures and timelines, with one describing the proposed timescales as “very ambitious”.

It added: “This didn’t prove possible during Org2 [a reorganisation of NHSD in 2018] for much fewer staff. What changes have been made that mean we can do it at that speed now?”

Many comments were focused on job security and redundancies, one of which asked: “Where can we find a list of the lessons learned from the last organisational change to see how the current changes are taking these lessons on board?”, received strong support from participants in the presentation.

NHSE declined to comment further.

*Updated at 9.30am on 14 November to remove the indication that NHSE was due to take on responsibilities from the Healthcare Safety Investigation Branch, as part of this change, which is not correct. The slide seen by HSJ indicates some staff may transfer from NHSE to HSIB, which is hosted by NHSE but operates independently.