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Senior nurses under threat in NHS England shake-up


Some of the most senior nurses working for NHS England could be made redundant under plans to cut a quarter of the organisation’s most senior clinical and managerial posts unveiled this week.

At least 75 of the organisation’s 300 most senior clinical and managerial posts are under threat, including many of the nursing directors of NHS England’s 24 area teams outside London.

Outside the capital area teams, which oversee NHS services in an area, currently all have nursing directors, along with medical finance and commissioning director posts. However, NHS England chief executive Simon Stevens is keen to streamline staff and adopt the model used in London where the three area teams do not all have their own nursing director.

Nursing Times understands the number of area teams outside London could be halved.

Hundreds more redundancies from lower down the pay scale are also expected as part of the shake-up with a consultation with nurses and other staff on band 9 or below of the Agenda for Change pay framework due to begin next week.

Details of the major shake-up of its senior staff structures is the second phase of an organisational review of NHS England, initiated by Mr Stevens after he took up his position in April.

In an email to staff chief executive Simon Stevens said the organisation, which is less than two year’s old, needed to change to deal with a reduction in government funding and in order to focus on its “core mission”.

He has previously suggested he does not see patient safety as a core function of NHS England, whose primary role is to commission primary care and specialised health services. Many nurses currently work in the patient safety directorate overseen by chief nurse Jane Cummings.

In the email, obtained by Nursing Times’ sister publication HSJ, he said the move to reorganize area teams to reduce the number of senior staff was “principally driven by the running cost cuts we are facing”.   

“In making these changes we will thereby minimise reductions required from less senior posts at other levels in our organisation,” he said.

All of the proposed changes are expected to be in place by April 2015.


Readers' comments (15)

  • The redundancy pay for senior nurses will be good. Then they can stroll into another job, or get hired by the same trusts for more money.

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  • Caution please: As 2012 minutes of NHS England suggest, previous reorganisations have almost certainly reduced the numbers of women, BME and (probably) disabled staff in senior positions.

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  • Losing a job, no matter how senior or not, is a loss, and none of us know when we will be next.
    Indeed I am an End of Life Education Facilitator (project post) and am about to lose mine despite it being one of the main focal points of care today!
    I therefore empathise totally with anyone in the same position.
    No doubt there will be criticisms about management being 'top-heavy' as there always are, and streamlining is a necessary evil.
    However, lets be sensitive in our responses and mindful of the things these people may have achieved or contributed too and that they will have lives also to maintain and continue!

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  • Kline's at it again with his disabled, female BME nonsense. The more senior nurses sat on their ars*s that are done away with the better whatever their gender, colour or disabilities.

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  • Having once trained & worked as a RGN/RM myself, I think the RCN have been very remiss in promoting nurses careers rather than focus on patient care. The increasinging tribalism I have seen between nursing and medical staff is due to the competition element which has been introduced between them, which means that patients are not at the centre of decision making, rather it is a progression of careers for staff. The requirement for nurses to be degree qualified means that many trained nurses are too posh to carry a bedpan, which is an amazing change from back in the days. At the same time, most of the nursing care is provided by HCA, who are not required to register, or have their training regulated. RCN is more interested in churning out career opportunities than to promote good quality patient care.

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  • EAch division has a director of nursing, as well as a medical director, as well as numerous deputy directors, all at band 9 or more; costing huge amounts in salaries & perks; CNS are a vital part of the hospital service and they do contribute to improving patient pathways, but nursing directors, forget it, they are egotistical as their counterparts in medicine; never wanting to delegate duties, means they appear to be overstretched, while their administrative staff have time to go online, because they are kept out of the cliques formed by these modern & matronly women who are just bossy boots mainly

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  • Read "Little Stories of Life and Death@NHSWhistleblowr,by Dr David Drew, a must read for all nurses, doctors and especially MANAGERS of the NHS!! The treatment of this brilliant Paediatrician and his team is absolutely despicable. And still it goes on, the "Sainsbury's" type managers are still in place.

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  • Having been through a horrendously handled redundancy and a resultant destruction of my career - I too sympathise - but agree there are too many executive managers on huge pay and too many CNS's being downgraded and paid a band 6 instead of a standard band 7 or 8A for enormous clinical responsibilities that do impact on pt care and prevent hospital admissions for many.

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  • Okay me being a very tiny small fry in the galaxy of NHS meaning a band 5 nurse who slogs for a living; please explain to me how this higher bands nurses care for the patients. Are they not administrators rather than nurses? I clearly remember when this version of matrons were introduced there was a flurry of them on the ward I worked. Much ado nothing should have been their title. Wait no, they do something eat away at the budget which is dwindling day by day. The salary of a matron can pay for a band 5 nurse and a HCA.

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  • Yes, more - much more, consideration hould be given the the CNS, the "real" patient carers.
    Any good ward clerk can do the job of most ward managers - just give one the opportunity and responsibility. They are also a whole lot cheaper and faster at the administration tasks.
    A waste of nursing skills(in most cases) sat in an office issuing orders and refusing to DELEGATE.
    The salary of a matron can pay for a band 5 nurse and a HCA and probably an administration assistant. Any bean counter knows that.
    Keep nurses nursing and get rid of nurses that have no actual patient care in their job description.

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