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One in ten NHS jobs will be axed in the next five years


The Department of Health has been told the NHS in England will need to slash its workforce by 137,000 if it is to achieve its planned £20bn savings by 2014.

This would mean the NHS losing 10 per cent of its workforce. The estimate was given to the DH in a confidential report commissioned from the consultancy firm McKinsey and Company, and seen by Nursing Times.

Although the DH has said the report was “purely advice and does not constitute government policy”, it bears the department’s logo and has been disseminated among senior NHS managers.

Proposed cuts

30,800 non-clinical posts, saving £600m

£3bn - saving potential of increasing staff productivity in NHS hospitals

£1.9bn - savings projected by cutting external contracts and supply costs such as waste and food

£1.3bn - saved by cutting unneeded appointments and procedures

£8.3bn - estimated value of hospital estates which could be freed up and sold

The McKinsey report makes clear the cuts will need to be felt as much among clinical staff as administrators.

Based on its analysis of different staff group efficiencies, it says the cut required to full time equivalents for an NHS hospital with a clinical staff of 300 would be: two consultants, one registrar, 10 nurses, 10 healthcare assistants, three allied health professionals and eight non-clinical staff.

The report recommends a range of “potential actions in the next six months” that should be considered. These include: a recruitment freeze starting in the next two years and an early retirement programme “to be implemented in the next two years” to encourage older community nurses and GPs to make way for “new blood/talent”.

The consultants also recommend that plans to increase staffing levels and investment, such as those set out in the national stroke strategy and the children’s service strategy, should be “reviewed”.

It says up to £600m could be saved by acute providers if those with above average ratios of non-clinical to clinical staff cut their administrators down to nearer the average level. Their £600m calculation was based on losing 30,800 non-clinical staff on an average salary of £20,000.

The analysis was presented to the DH in March this year and was shared with senior managers at strategic health authority level - several weeks before NHS chief executive David Nicholson said publicly the NHS should be planning to make up to £20bn in savings by 2013-14. Although some of the findings have been cited outside senior management circles the full analysis has been on restricted access.

The analysis sets out how up to £8.8bn of new recurrent annual spending could be cut from the NHS by 2013-14. It says the biggest chunk - up to £3bn - could be saved by increasing staff productivity in NHS hospitals. The second biggest saving is in non-acute staff productivity (up to £1.9bn) and in driving down costs of external supplies and contractors such as waste and food (up to a total of £1.9bn in savings).

McKinsey’s breakdown of the types of NHS organisation the savings are likely to come from reveals that acute providers will be hardest hit, with cuts equivalent to up to 38 per cent of their 2008-09 spending by 2013-14.

The smallest savings would fall on primary care, where spending would reduce by up to 13 per cent. Community care budgets could be cut by up to 28 per cent.

Health minister Mike O’Brien played down the report’s significance. He said: “Advisers advise but minsters will decide after taking a range of advice.”

He added: “The McKinsey work… is not in any sense an NHS plan of action. They are just making some suggestions which will be looked at with many other ideas.”


Readers' comments (5)

  • One hopes that the huge fees paid to providers of continuing care will be put in the pot when it comes to making savings. Some placements attract 100% profit year on year on placements costing PCTs 100k+ per year.

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  • What is meant by productivity? FFS this is not tins of baked beans we're talking about but the NHS & people.
    Is it too much to ask that our so-called betters & leaders cannot see that with our ageing & sickening population more staff are needed on the "front line"?
    Managers & ministers are only interested in meeting targets & Foundation status; staff on the wards are being worked to breakdown & still they say cuts are needed.
    This disgusts me - we're all happy to pay sportsmen & actors fortunes but people doing important jobs such as nurses & soldiers are paid peanuts & forced to work in intolerable situations.
    I'd love to see how managers would cope with running a ward or caring for a group of patients - they'd soon see how "productivity" can be increased.
    A revolution is needed!!

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  • Is this a JOKE??? Having not eaten for 2 weeks last month, and working long shifts being mentored by an excellent general surgery staff nurse looking after 8-10 beds of chronically ill patients I ask myself is it really worth it? Bursary just about covers rent for students in london - forget anything else. I haven't worked one day that hasn't been understaffed. Most students are leaving the country as soon as they are qualified... I guess that may be an option for me too... or maybe recruit people that are going to work for the NHS only as you're paying for the fees! (Not rocket science). Worked in hospital admin as a temp for 18 months and was doing the job of 3 people in the office as the perminant staff were always sick - get graduate hardworking people for admin and cut costs...

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  • "it says the cut required to full time equivalents for an NHS hospital with a clinical staff of 300 would be: two consultants, one registrar, 10 nurses, 10 healthcare assistants, three allied health professionals and eight non-clinical staff"
    This is simply disasterous - there is no way that a hospital can function without these key staff. You only have to go onto any ward in this country to find that wards are understaffed, yet management positions are over filled. In my Trust we have SIX Band 6 managers on a day shift - that is the equivalent of ONE whole wards staffing level. What do they do - that is a mystery to anyone that has actually dealt with them. To lose a total of twenty useful staff would be a disaster.

    This would be a disater for the NHS and result in patient deaths, staff will simply leave the NHS. What does this say to the nurses of the future...

    I cant belive that someone would seriously consider this. Get rid of the management in the NHS it is they who are over staffed and of no use to anyone.

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  • Whats this about an early retirement programme? Bring it on I say!! There is no need for nurses to lose their jobs as thousands of nurses are leaving each year due to retirement, change of career or to move abroad. There wil come a time when patients will have their basic cares attended to by family and medication will be given by machines programmed to dispense the correct calculations of drugs to each individual patient by their bedsides!!

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