Home > News > Precious few and far between: how the NHS job cuts are starting to bite

Precious few and far between

Ryhs McKenzie
Woman manager working alone in open plan office, daytime, surrounded by empty desks.

When major public sector reform is announced, attention usually focuses on those who leave. People who are losing their jobs, and maybe their livelihoods, often need immediate support. And the loss of their knowledge, skills and experience can significantly affect the organisations they once worked for.

But the experience can be equally unsettling for staff staying in the new structure. They face uncertainty, increased workloads and the pressure of maintaining services during significant upheaval.

Doubling up

It’s common for staff who stay on after major organisational change to be expected to pick up more work, says Sam Crane, MiP’s national officer for the East of England and North London.

“I’ve just came off a meeting this morning,” she says, referring to an ICB where voluntary redundancies are underway. “There were five people in the team—there’s one left. That one person is now covering what work used to be done by five people. It’s unacceptable.”

The employer says that once the full reorganisation is complete the remaining team will have less work than before. But in Sam’s experience, workloads don’t necessarily reduce. And even if they do, eventually, what about now?

The transition period can be especially challenging. Staff may take on new roles while still carrying their existing responsibilities. “With staff leaving now and the form and function of the new organisation not yet finalised, somebody’s going to have to double up,” says Sam. “MiP members tell me, ‘I’ve got a new job, but I can’t drop the old job until April.’”

Juggling these competing priorities creates pressure in terms of capability as well as workload. When senior managers leave and are not replaced, “that work doesn’t just disappear” says Sam. Staff at lower grades are often expected take on that work without additional support or recognition. “You’ve got rid of these layers… and you want people to pick up all those roles and responsibilities, which is a different level of working,” she explains.

And when organisations are merging, you have the added complexity of staff being pooled for jobs away from their usual workplace. “You’ve got staff all working in different places that have been merged into one, so where’s their base? It’s a minefield,” Sam says.

Moral injury

As well as workload pressures, redundancy situations can have a significant emotional impact on staff who stay on.

Staff wishing whose posts are marked for redundancy must undergo what Sam calls a “horrendous” pooling process if they want to stay on. Colleagues are effectively required to compete against one another for a limited number of jobs. Those who are successful may feel relief, but they know it likely comes at the expense of a colleague who will lose their job.

This can be made worse when job descriptions are so generic that it becomes almost impossible to meaningfully differentiate between candidates.

MiP hears from members that the moral injury sustained by those who stay can be quite overwhelming. While she recognises that employers do try to support people, “all the wellbeing and interview support offered doesn’t take away that anxiety,” Sam says.

Staff exits can be abrupt—there are often no goodbyes, no leaving dos, no extensive handovers—colleagues just vanish. “One day you’re chatting with your colleague in the office, on Teams, working on projects together—the next they’re just gone. It can be really debilitating,” Sam says.

Take action, get support

Your employer has undergone a major reorganisation and significantly reduced its staff. Some functions have gone but new ones have been taken on. You’re slotted into a new role, but what was a five-person team is now just you and a senior manager. Your workload inevitably increases and you begin taking on more and more delegated responsibilities from your manager. Do you have any recourse, or do you just need to adapt to this ‘new way of working’?

“Absolutely you have recourse”, Sam says. If your role and/or workload has significantly changed during or after organisational change, she advises updating your job description and objectives with your line manager. “If it’s changing, get it down on paper, get it agreed with your line manager—that’s the first step,” she says.

If it’s agreed that you’re working at a different level, you can ask for your job to be re-evaluated. This could lead to your job being graded at a higher-level, meaning you will be paid fairly for the increased responsibility. MiP can support members who believe their job needs re-evaluating.

In terms of workload, staff should try to document the additional work they’re expected to deliver, Sam says. “If a five-person team becomes just one or two, then work naturally must come out of that team. The employer must be clear about what work stays and what goes—one person can’t be doing the job of five people.” She recommends discussing workload issues with your line manager in the first instance to agree fair and reasonable duties for the role.

Where possible, MiP also strongly advises members to formalise their current working arrangements as soon as possible during organisational change. For example, if you work flexibly with the support of your current line manager, it’s best to have this formally agreed. You may not have the same assurances after the reorganisation. Your local MiP reps can support you with this.

Employers can do more

I asked Sam if it’s reasonable to expect employers to do more to support staff during the sort of massive politically-driven restructuring going on in England—or are they just navigating in the dark like everyone else?

Sam recognises that the scale and speed of the government’s changes, combined with a lack of clarity about how they will be delivered, has made the process extremely difficult for employers to manage. However, many can and should be doing more, she says.

Clear, consistent and early communication is vital, Sam explains. Staff are being offered voluntary redundancy without knowing the future form and function of their organisation. Many people want clarity—even if that means redundancy—but they may miss out on opportunities in new departments, new teams and new roles that would have appealed to them if they had known those opportunities existed.

It is essential for employers to thoroughly audit existing skills within their workforce before recruiting externally, particularly while staff are at risk, Sam says. “You need to be very careful before you send an advert out when people are sitting there losing their jobs—what message does that give?” Looking across the whole organisation, rather than within narrow silos, can help to identify redeployment opportunities, prevent unnecessary loss of expertise and reduce anxiety among staff who fear they are being overlooked, she suggests.

Sam also urges employers is to allow form to follow function. “I’m pleading with employers to wait until after the new organisations are in place before changing policies on areas such as flexible working, on call arrangements and in-person working,” she says. Where multiple organisations like ICBs are merging into one, there are often competing policies and different expectations among staff. “Wait until everyone is in place, the functions of the organisation are clear and then review as one organisation and as one workforce,” she adds.

When redundancies happen, the people left behind mustn’t become an afterthought. They often face increased workloads and heavier responsibilities, as well as bearing the emotional toll of a chaotic reorganisation in which many of their colleagues disappear almost overnight. Managing change with clarity and fairness not only protects staff wellbeing but is essential to ensuring the organisations that emerge are stable, effective and capable of delivering on their new priorities. //

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