Daily Insight: Pretty vacant

Hundreds of posts are being held back under NHS England’s major restructure as many staff face the risk of redundancy and having to apply for new roles.

Steve Russell, NHSE’s chief delivery officer, has told staff that around 5 per cent of total roles – or 860 out of 17,000 – will be kept vacant throughout 2024-25 to help cut costs further.

The organisation plans to remove about 9,000 posts (30-40 per cent of its total) after having merged with Health Education England and NHS Digital.

However, staff have voiced frustrations over the final phase of the restructure, while some believe they have been misled about which jobs would be made available to them. The “transformation”, as well as “workforce, training and education” directorates are expected to be hardest hit.

Mr Russell said: “We are not changing our organisational design in a way that would require further formal change or consultation, and we are not halting recruitment.

“This is about prioritising roles so we all do our bit and put as much [funding] back into frontline care as we can.”

NHSE’s restructure was expected to finish in autumn 2023 but staff have been told since that they will know their position by this spring.

A crucial upgrade

Legacy IT remains worryingly common in the health service, although inroads are being made to modernise hospital technology.

A good example of this is happening in Devon, where Torbay and South Devon Foundation Trust has announced a preferred provider of its new planned electronic patient record.

The new system – supplied by Epic – will replace more than 25 old IT systems, including a patient administration system installed in the 1980s. Trust chiefs believe this to be the oldest IT system in the NHS today, although Daily Insight would not be surprised if an older system exists somewhere in the depths of England’s hospitals.

The deal is crucial to TSDFT, which has an ageing physical and digital infrastructure that affects the trust’s ability to run services efficiently.

Further investment is planned to modernise the physical estate through the government’s New Hospitals Programme, which means the trust should undergo a dramatic change this decade. 

The Epic deal is also noteworthy from a Devon perspective, as Torbay’s hospital neighbours in East Devon (Royal Devon and Exeter and North Devon District hospitals) both use Epic.

This might make it easier to clinically optimise patient pathways across the trusts where needed, and is in line with NHSE’s EPR convergence policy.

But TSDFT must try to avoid some of the IT issues that have dogged trusts which have implemented Epic. Learning from experiences at Cambridge, Manchester, Frimley and Exeter would be a good start.