Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Regulator tells NHS trusts to curb clinical staff growth

  • 17 Comments

Interventions taken by regulators in the coming weeks to regain control of NHS finances could result in some providers having fewer clinical staff, Nursing Times’ sister title HSJ has been told.

Efforts to reduce the provider deficit are set to focus on 30 - 40 trusts where the pay bill either increased substantially last year, or which have planned for growth in 2016-17.

In an exclusive interview, Jim Mackey, chief executive of new regulator NHS Improvement, said trusts exceeding the ratio of one nurse to every eight patients could be told “we can’t afford that”.

Mr Mackey said some of that pay bill growth might have been justified, but his team are in the process of exploring where growth that took place last year can be “corrected”, and planned growth for 2016-17 can be ”mitigated”.

”A lot of providers ended up using bank and agency [staff] to try and get close to the safe staffing recommendations, but some went beyond that 1:8 ratio”

Jim Mackey

He said “it is possible” this will lead to fewer clinical staff on wards, adding: “I can think of a couple of providers that went beyond the safe staffing requirement.

“A lot of providers ended up using bank and agency [staff] to try and get close to the safe staffing recommendations, but I’ve met with some that went even beyond that 1:8 ratio from a nursing point of view.”

Mr Mackey said NHS Improvement would scrutinise pay costs across the entire provider sector, not just acute trusts.

The NHS provider sector reported a deficit of £2.45bn in 2015-16, leaving the Department of Health with a huge financial hole to fill in its year-end accounts, which are due to be published this month.

The sector has planned for a deficit of £550m this year, but regulators expect this to reduce to £250m.

Mr Mackey said it was too early to say how much of the pay growth was unjustified, adding: “We’ll have a better feel at the end of this process. By the end of July we want to be really clear what that means for each provider’s plan, so how much of it can be corrected and what’s the timescale.”

A key principle for NHS Improvement was to bring “more fairness and equity” between providers, Mr Mackey said. “If you’re an organisation that has exercised real restraint, and next door an organisation is performing the same or better and has exercised less restraint, that’s potentially quite toxic”.

”[I’d be] surprised if there was a provider that actually has to have a huge lay off process”

Jim Mackey

The process, he said, is about “just restoring good discipline, good governance, and good processes that have continued to exist in our best providers”. 

He said substantive staff as well as agency workers accounted for the pay growth, but he would be “surprised if there was a provider that actually has to have a huge lay off process”. He suggested numbers could be reduced by voluntary redundancies or leaving roles vacant.

There was expected to be an announcement later this week, dubbed a financial “reset”, which will outline the consequences for providers that fail to improve their financial situation.

Jim Mackey

Jim Mackey

Source: Neil O’Connor

Jim Mackey

HSJ understands the consequences would involve an assessment of board capability and potential changes to senior personnel, with consideration given as to whether the organisation should be merged or taken over by another trust.

Mr Mackey denied that pay cost growth was a legitimate reaction to rising demand. “When everyone says activity went up 2 per cent, therefore cost needs to go up, no it bloody doesn’t.”

He added that some providers were “on the edge of going out of business” and were close to not having enough cash to pay staff.

 

 

  • 17 Comments

Readers' comments (17)

  • As we all know but are never given the chance to state our case it is high time that healthcare workers INSIST that the likes of Mr Hunt have REAL qualifications in healthcare and MUST have worked on the frontline in the NHS themselves !! No more damn useless politicians on over inflated salaries telling the rest of us what we are worth !!
    Then and only then can they really appreciate what level of care is required to deliver the so called " excellent standards" they claim they can deliver on an ever decreasing budget !!

    Unsuitable or offensive? Report this comment

  • What the .......? Curb the growth? How about curbing the decline?

    Unsuitable or offensive? Report this comment

  • michael stone

    Politicians do have their own peculiarities - see my BMJ comments:

    http://www.bmj.com/content/353/bmj.i3237/rr

    http://www.bmj.com/content/352/bmj.i1133/rr-0

    Which are relevant to Jill Garnett's comment.

    Unsuitable or offensive? Report this comment

  • michael stone

    I've just noticed a wonderfully acerbic BMJ comment from Susanne Stevens at:

    http://www.bmj.com/content/352/bmj.i1133/rr

    The article Susanne (and I) responded to was titled 'What would a “responsible health secretary” do?' and Susanne sent in:

    Get more rest. Tired politicians kill.

    Unsuitable or offensive? Report this comment

  • Don't blame Brexit this is right wing ideology of keep it lean and mean and maximum monies for fat cats.

    Unsuitable or offensive? Report this comment

  • When I am sick I want a caring skilled individual looking after me that is not doing three or more jobs to make ends meet. I am tired of the balance sheet coming first except when it comes to executive pay. Most organisations would function just as well clinically with the top three or four levels of management removed. The internal market and private provision is what is bankrupting the country, not a couple of trained nurses on a ward.

    Unsuitable or offensive? Report this comment

  • michael stone

    16 July, 2016 9:40 am

    If you really have strong views about 'the internal market' there is a contemporary BMJ 'Head to Head' article called 'Should the NHS abolish the purchaser-provider split?' which is at:

    http://www.bmj.com/content/354/bmj.i3825

    You could send in a rapid response to it.

    I am 100% with you re:

    'When I am sick I want a caring skilled individual looking after me that is not doing three or more jobs to make ends meet.'

    I'm also with you, in that if 'pay restraint' is necessary, it should apply all of the way up the organisation.

    Unsuitable or offensive? Report this comment

Show 1020results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.