Half of NHS England staff may face the sack

The organisation’s 6,500 bureaucrats could be culled to ensure extra £3billion goes to front-line services

‘Over 50,000 people aren’t in patientfacing roles, so there’s an opportunity to merge those’

‘When I talk to trust leaders, one of their frustrations is just the sheer amount of time they spend managing upwards’

UP TO 50 per cent of NHS England staff face the sack under plans to give local hospitals more power.

Ministers want to slash the budget for NHS England’s 6,500 bureaucrats by as much as half and to cut central targets to free up hospitals to decide how they meet the needs of patients in their areas.

They favour a system modelled on the Tories’ school reforms where freedom for headteachers was backed by Ofsted inspections and exam league tables to hold them to account, leading to the UK rising nine places up the international education ratings.

The shake-up is expected to be spelled out in an NHS review commissioned by Jeremy Hunt, the Chancellor, and Steve Barclay, the Health Secretary, to find ways of giving hospitals greater autonomy, reducing “Stalinist” national targets and making them more accountable for their performance.

They want to ensure the extra £3.3billion pledged for the NHS in the Autumn statement last week is spent on front-line services rather than being soaked up by bureaucrats.

A Government source said: “Steve wants to cut out the pointless box-ticking and red tape so NHS staff can focus fully on caring for patients. He is determined to ensure every penny of investment goes into fixing the service rather than being squandered on ever-expanding layers of management.”

Before he became Chancellor, Mr Hunt said the NHS needed to ditch the “Stalinist centralism” that had given it more targets than any healthcare system in the world. GPS alone were tracked by a “whopping” 72 indicators which made them the “most micromanaged” on the planet.

NHS England is already facing up to a 40 per cent cut in its staff budget but ministers believe it could rise to 50 per cent under the review that will be led by former Labour Health Secretary Patricia Hewitt.

Ministers believe the review by a Labour grandee, who also chairs the local integrated care system in Norfolk, will stymie political flak of the reforms.

Mr Barclay told the BBC’S Sunday with Laura Kunessberg that the Department of Health had 50,000 employees in quangos and arms’ length bodies costing the taxpayer £2.8billion. “That’s over 50,000 people that aren’t in directly patient-facing roles, so I think there’s opportunities in terms of merging those,” he said.

“It’s about looking at a local level how we design a healthcare system in a way that more empowers local leaders, better uses the population level data that we will have, and less diktat from the centre in a one-size fits all.

“That is one of the things those within the NHS tell me is causing a lot of noise, causing a lot of disruption and actually getting in the way of them delivering patient care … When I talk to trust leaders, one of their frustrations is just the sheer amount of time they spend managing upwards.”

Mr Barclay has ordered all armslength bodies to publish “organograms” of their management structure to show what they do and how much they earn.

The first, by NHS England, showed 430 bureaucrats employed on over £100,000 each a year, of which a quarter were on at least £150,000. Forty-five earned more than the Prime Minister’s £164,000.

Major central targets such as ambulance waiting times and cancer treatment would remain, but others such as the aim of admitting, transferring or discharging 95 per cent of patients coming into A&E within four hours – which has not been met since 2015 could be scrapped.

Mr Hunt is understood to be pushing to axe all but a “handful” of national performance measures, with sources saying that the hundreds of targets could be hacked down to just five or six.

Speaking yesterday, Mr Barclay also said the Government had not abandoned the promised reforms of social care as he acknowledged the NHS was under “severe pressure.”