Plans to cut tens of thousands of management and support staff jobs at NHS trusts in England are “going under the radar” and risk damaging patient care and undermining efforts to reform services, MiP has warned.

Research published by UNISON suggests NHS trusts are planning to cut at least 21,000 jobs by 2028 as they try to meet increasingly challenging financial targets. The findings come as providers face significant financial pressures, with trusts collectively reporting a deficit of more than £1.1 billion last year.

UNISON says the true scale of workforce reductions is likely to be higher, as not all trusts were able to provide complete responses to the union’s Freedom of Information requests.

The research suggests that at least 3,600 clinical jobs are due to be axed, but the majority of cuts are targeted at management, corporate services and support staff. These cuts are on top the estimated 20,000 job losses already taking place at NHS England, Commissioning Support Units and ICBs.

MiP chief executive Jon Restell said many of the changes at providers were “going under the radar” because of the governments more widely-publicised reforms to NHS England and ICBs—despite the potential direct impact on service delivery.

“Too often, cuts to management and support roles are presented as if they have no impact on patient care. The reality is very different” he said. “Every hour a doctor or nurse spends on administration is an hour they are not spending with patients.

“We should be making the best use of highly trained clinical staff,” he added. “That means ensuring they can focus on treating patients, not filling gaps left by reductions elsewhere in the workforce.”

The research also suggests the cuts are having a significant impact on the existing workforce. A survey of almost 20,000 NHS staff found that nearly two-thirds reported increased workloads and higher levels of stress following job cuts or vacancy freezes.

The cuts were particularly damaging at time when NHS staff “are already stretched to breaking point” and “morale is through the floor” warned UNISON head of health Helga Pile. “The public are all too aware how understaffing is a major problem, so they’ll be rightly alarmed when the situation’s getting worse.”

The report comes as trusts face mounting pressure to reduce waiting lists, improve productivity and balance their budgets, while also preparing to implement the government’s Ten Year Health Plan.

Restell said managers were “central” to delivering those objectives, and warned it was “false economy” to cut management capacity.

“They are the people who redesign services, improve patient flow, tackle inefficiency and support clinical colleagues,” he added. “Cutting those roles risks undermining the very improvements ministers want to see.”

MiP has called for more oversight of workforce reductions and joined UNISON’s call for NHS organisations to be able to expand their workforce to meet growing demand, rather than reduce staffing “to achieve short-term financial targets”. //