More than 3,000 NHS job cuts have been announced in the last month. Further culls are expected, with some politicians predicting the loss of 20,000 jobs overall. The cuts are an attempt by the health service to plug a deficit that is estimated at between £620m and £750m. For example, it has been reported that Royal Free Hospital in Hampstead hopes to achieve savings of £25m in the next year by axing 480 posts. Critics say escalating payroll costs are to blame, largely due to the Agenda for Change programme. Agenda for Change, still being implemented across the UK, is the biggest overhaul of NHS pay, terms and conditions in more than 50 years. Michael Pyrah, president at the Healthcare People Management Association, agreed that it has caused substantial financial problems for the NHS. “Costs are higher than projected, but I’m not sure that is all the fault of Agenda for Change. We have to question how we implemented it as some organisations have redesigned jobs better than others.” Those organisations and HR departments that thought through the modernisation changes properly and how best to implement them, have incurred less costs and experienced more benefits than those who rushed the scheme through, Pyrah said. He also said that the change had to happen, whether it cost more than expected or not. “We must not forget we had to do it as the old payment system was archaic. New arrangements and pay system do tend to cost you more. It has given us financial problems but it will deliver benefits.” Many of the job cuts will result from decisions not to replace staff when they leave, rather than through redundancies. Compulsory redundancies are the last option, said Emma Stafford, spokeswoman for NHS Employers, the body responsible for workforce conditions in the NHS. “Organisations are doing their best to avoid making compulsory redundancies among clinical staff.” Greater efficiency and improved job roles are helping organisations to reduce costs, she said. “Many organisations are developing new roles for staff and new ways of working that mean greater efficiency as well as improving services for patients. This may result in staff being redeployed to other organisations or long-term vacancies no longer needing to be filled.” Agenda for Change and changes to GP contracts necessitated a huge investment in new IT systems. This was costly, but Pyrah hopes that over the next five to 10 years NHS and patients will see the benefits. For example, services that people traditionally visit hospital for, such as diagnostic tests, minor surgery and consultant appointments, should be able to take place at a patientÍs home or the GP’s surgery. Good HR practice is critical to successful implementation of Agenda for Change. Pyrah thinks the function has a vital role to play. “HR has to look at how best to reduce costs, dealing with staff, communicating with them and dealing with morale and motivation issues,” he said. “HR advice has to be an integral part of the recovery process. It canÍt be seen to be accountant driven.” HR also needs to ensure that long-term needs are not damaged by short-term measures to reduce costs, Pyrah added. “The NHS has severe financial problems and the only way out is to reduce workforce costs. But, we have to think carefully about how to avoid a boom and bust economy for NHS staff,” he warned.
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