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Two cheers for ICB reforms but job fears remain

By MiP

MiP members in England have given a cautious thumbs up to the transition to Integrated Care Boards (ICBs) in the NHS, but a significant number face possible redundancy or are still in the dark about the how the reforms will affect their jobs, according to an MiP survey.

In the survey of 140 members affected by the reforms, carried out in February, participants rated their experience of the transition as 57 out of 100, but with a significant number giving very high or very low ratings. The delayed timetable for setting up ICBs, which will now open for business in July 2022 instead of April, was less positively received, attracting an average rating of 43 out of 100.

While only 2% said they had been given notice of redundancy, one in seven participants said they were "at risk of redundancy" and 26% said it was unclear if they would have a job in the new structure. Less than half (42%) said they fully expected to transfer smoothly to the ICB under NHS England's employment commitment.

"At the moment, I have no idea," one member wrote. "I have asked on a number of occasions, through a number of avenues, and am getting no response." Another manager reported that it was "unclear who is responsible for what and who answers to who. All of this makes for a very demanding, challenging and often toxic working relationship with the system and with NHSE/I."

MiP chief executive Jon Restell said he was "very concerned by the variation in experience for the same process" revealed by the survey. "It's clear some managers have had a very positive experience, while others are having a very difficult time and feel they're being kept in the dark about what's happening to them.

"Given that there's still a lot of uncertainty around these reforms, we are pressing employers and NHS England to ensure managers are treated consistently and fairly throughout and that guidance on the employment commitment is being followed," he added.

Over a third (35%) of participants said they had unresolved worries about how the transition would affect them. These included "loss of status" or demotion for managers currently in board level posts, "poor communications", out-of-date job information being used to match people to new posts and the continuing lack of job security if, as many expected, there were further re-organisations after July. Several members also complained about "bias" in the selection process and a "lack of diversity" on the new boards.

Many also raised concerns about the risk of "burnout" from increasing workloads and prolonged uncertainty. "My workload has practically doubled," one member wrote, "because I'm expected to provide information for and attend ICS meetings around integration as well as carrying out the same work for the trust."

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