Giving oral evidence to Parliament’s Health Bill Committee, MiP Chief Executive Jon Restell highlighted to MPs the impact that ongoing NHS restructuring is having on members and the wider health service.

During the session, Jon stressed that while many NHS managers support the need for reform, the approach taken by government ever since the system changes were announced has deeply damaged confidence in the process. He told MPs that the NHS already has a limited management resource compared with other health systems and warned that further reductions risk undermining the government’s own reform agenda.

Jon pointed out that even the government’s own adviser Lord Darzi, commissioned by them to review the state of the NHS in England, concluded that the NHS’s slim management capacity is weakness, not a strength. Jon said “what is going on right now is knocking another big hole in an already limited resource of managers in the health service.”

He argued that managers are the people who turn policy into reality and that removing large numbers of experienced staff risks losing valuable skills, expertise and tacit knowledge at a time when the NHS is being asked to undertake major change.

Jon also highlighted the uncertainty facing many NHS managers and leaders. Eighteen months after the announcement of major structural changes, significant questions remain about how the future system will operate, where functions will sit and how responsibilities will be shared across organisations.

He told MPs that many staff are being asked to make decisions about voluntary redundancy and their future careers without having a clear picture of what the future NHS structure will look like. This uncertainty is creating significant anxiety and distress, leading to some experienced staff leaving the service altogether.

He warned that “people are being told to make decisions about voluntary redundancy and the future where they do not understand where that future potentially sits for them… people are beginning to leave, because they need to protect themselves.”

The Committee also heard concerns about the potential impact of the changes on patient care and service delivery. Jon warned that as organisations reduce management capacity, operate across larger geographical areas and more power is concentrated in Whitehall, there is a risk that local knowledge and opportunities for innovation could be lost.

He said “we are taking out a lot of staff who have skills, expertise, organisational memory and commitment, but we do not quite know yet what the precise form of those organisations will be.”

Jon emphasised that structural reform alone will not deliver the improvements the government seeks. Successful reform requires sufficient management capacity, clear organisational design and meaningful engagement with the people responsible for delivering that change.

MiP will continue to raise members’ concerns with Parliament to advocate for a reform programme that supports staff, protects services and gives managers and leaders the tools they need to deliver improvements for patients.