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Exclusive: DH job cuts spark fears of lost voice at national level

  • 10 Comments

Leading nurses have raised serious concerns about a loss of vital nursing expertise and influence over policy at the highest level after the Department of Health outlined proposals to cut up to 700 jobs.

Under the confidential plan seen by Nursing Times, the department’s workforce will reduce from 2,000 to around 1,300 to 1,400 over the course of this parliament.

“Losing one DH nurse could have an impact on ensuring the voice of nursing is heard loudly and clearly in central government”

Gail Adams

The plan – circulated to DH staff – sets out how the department must change to cope with having a third slashed off its budget.

DH insiders have confirmed the few posts currently held by those with nursing expertise are all at risk amid the re-organisation, prompting fears the profession will lose vital input in high-level policy with a knock-on effect on frontline care.

“We will lose that impartial voice in nursing leadership and sophisticated handling of policy will suffer,” warned one source.

The move comes amid ongoing concern that nursing’s influence at the department has been diluted, after the chief nursing officer role moved to arm’s-length body NHS England in 2012.

Richmond House 182

Richmond House 182

Richmond House

In addition, there is no longer a director of nursing based at the DH, following Professor Viv Bennett’s move last year to Public Health England to become its chief nurse and the government’s principal advisor on public health nursing.

The latest round of DH job cuts – to be made at all levels – will start with the executive committee and a reduction in the number of director generals by April next year.

The number of directors will fall from 25 to around 16 to 18, the number of deputy directors from 116 to around 70 to 80 and other civil servant and professional adviser roles will be cut from 1,800 to between 1,200 and 1,300.

Roles under threat include those at the Nursing, Midwifery and Allied Health Professions Policy Unit. The unit has already seen staff reduced from nine to seven, meaning key policy advisers are “all doing basic admin, which is not the best use of their talents”, said a source.

Gail Adams, head of nursing at Unison, said it was vital to retain nursing expertise within the DH.

Gail Adams

Gail Adams

Gail Adams

“There are only a handful of nurses in the DH now, so just losing one of them could have an impact on ensuring the voice of nursing is heard loudly and clearly in central government,” she said.

“The chief nursing officer now sits within NHS England, but it’s absolutely vital the health minister retains a nursing team within the DH,” added Ms Adams, who said losing senior nurses at the top would damage the profession as a whole.

“If you start to get rid of nurses and feel that anyone can advise on nursing you devalue the profession,” she said.

“You need a strong advocate for nursing and nurses to continue to make sure the importance of our role is heard, understood and appreciated and respected at the highest level,” she said.

“If policy isn’t influenced at the top then that filters down through the system”

Audrey Emerton

Last month the DH and its arm’s-length bodies published a “shared delivery plan” setting out their joint priorities up to 2020. The DH’s internal re-organisation plan includes looking in detail at the department’s role and relationship with agencies like NHS England, Public Health England and Health Education England.

It will include a workload assessment looking at where there is overlap between the organisations and could mean senior nurses in the arm’s-length bodies taking on more responsibility.

“If nurse leadership is being rubbed down at the DH, it could mean nurses in bodies like NHS England become more important as the only national nurse leaders left in the system,” said Jon Restell, chief executive of union Managers in Partnership.

But others said a key advantage of having nurses actually working within the DH was they were able to “get in under the radar” to influence policy teams without getting caught up in the politics and varying priorities of different agencies.

Audrey Emerton

Audrey Emerton

Audrey Emerton

Baroness Audrey Emerton, former senior nurse and now a cross bench peer in the House of Lords, claimed nursing was “very often put down” at the highest levels of government and it was vital the profession was represented by people who truly understood it.

“I believe there should be a nursing voice at the top – in the Department of Health, NHS England and at every trust – a strong leadership voice involved in policy and able to influence and persuade change,” she said.

“If policy isn’t influenced at the top then that filters down through the system,” she added.

But Lisa Bayliss-Pratt, director of nursing at Health Education England, said there was “very strong alliance of senior nurse leaders” across the arm’s-length bodies under the leadership of the CNO.

Lisa Bayliss-Pratt

Lisa Bayliss-Pratt

Lisa Bayliss-Pratt

“What we have done over the last three and a half years together is build up a strong network so we have system leadership and we do have a voice in nursing at every level,” she said.

“There are always concerns when things change and about the pace and scale, but we do have a very strong senior nurse leadership that is headed up by our CNO.”

A DH spokesman confirmed the fate of specific roles had yet to be decided and said this would not happen until the department’s new permanent secretary, David Wormald, was in place later in the year.

“It has not been specified at the moment which roles are going to go, but it will be pretty even at about 30% at each grade level,” he said.

  • 10 Comments

Readers' comments (10)

  • michael stone

    It isn't clear to me, that nursing ever had 'a strong top-level voice'.

    The DH staffing levels seem to be reducing rapidly. I made contact with one chap at the DH a few months ago, in connection with some MCA issues, and he told me 'we are very small teams now' or something like that. He left his post (and I suspect his 'job' has gone as well) this Easter, which may or may not be 'connected with' this round of cuts. But it seems clear, that the number of people in the DH is being dramatically reduced - and some of those left, are perhaps becoming 'jacks of all trades'.

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  • Then perhaps Directors of Nursing will have a stronger voice and stand up and be counted without the clutches of the DOH and political meddling?

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  • I am not too sure the impact of nurses at the top anyway. Nurses pay is extremely poor. No nurses on the wards. Patients expectation are high. Nurses have to work extremely hard to meet patients needs. some nurses study so hard but had to stay in the same band for over ten years. The list is endless...

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  • I am not too sure the impact of nurses at the top anyway. Nurses pay is extremely poor. No nurses on the wards. Patients expectation are high. Nurses have to work extremely hard to meet patients needs. some nurses study so hard but had to stay in the same band for over ten years. The list is endless

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  • since when were nurses ever valued

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  • To all of you who voted Conservative, you reap what you sow!

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  • "If you start to get rid of nurses and feel that anyone can advise on nursing you devalue the profession,” she said... Devalue the profession. Don't want particularly to be an eeyore on the subject, but I think that's exactly what this government is seeking to do e.g. see doctors...see teachers. Someone said, possibly Liam Donaldson, they're treating these, talented, brilliant, dedicated doctors... as functionaries..He's not wrong. See it's happening. Do all you can and must to call a halt to the dismantling of professions.

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  • "The number of directors will fall from 25 to around 16 to 18, the number of deputy directors from 116 to around 70 to 80 and other civil servant and professional adviser roles will be cut from 1,800 to between 1,200 and 1,300."
    What on earth are these people doing, bearing in mind that NHS England seems to have developed a completely parallel organisation, also employing large numbers of people? (And I am aware that these numbers are mainly not of nurses, by the way)

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  • M stone where is the evidence to support your statement in your uninformative post? as usual, you are commenting just for the sake of it in an attempt to meet your own cathartic ends rather than adding anything of value to the thread.

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  • michael stone

    ANONYMOUS 10 APRIL, 2016 8:37 AM

    Which part did you want 'evidence for' ?

    The second part - about DH staffing these days - was self-contained in terms of 'evidence'.

    And some other posters, also seem to agree with my first sentence.

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