Westcountry health workers to pay for cuts

Thousands of people working at Westcountry health trusts could be asked to work extra hours for free, give up holiday entitlement and earn less for night shifts in exchange for keeping their jobs.

In an eagerly anticipated document, the South West Pay, Terms and Conditions Consortium (SWC) today publishes a business case which outlines how tens of millions of pounds can be saved – but at a cost.

The Western Morning News has been given exclusive access to the report to be handed to members of the organisation – 19 health trusts in the region, including the Royal Cornwall Hospital, Derriford and the Royal Devon and Exeter Hospital.

The SWC say unprecedented financial challenges mean that the average health trust must cut £15 million from their budget over three years with an estimated 65% of this coming from payroll costs.

The size of the challenge facing participating trusts is said to be the "equivalent to a reduction in whole time equivalent of around 6,000 posts over the next three years across all consortium organisations."

Chris Brown, chairman of the consortium steering group, said these were bleak economic times and health trusts were not excluded from austerity.

"These are major challenges," he told the WMN.

"The levels of savings that we need to achieve over the next three years is equivalent to 6,000 average paid jobs.

"This is the size of the challenge. It's a lot of people and a lot of jobs.

"We don't believe [losing that number of jobs] is desirable or achievable and it is therefore not acceptable.

"This is not a small issue it is a big issue.

"This is not about saving a bit of money on paper clips or sacking two managers, this is about a challenge we all have to face up to."

The business case released by the SWC will make uncomfortable reading for tens of thousands of NHS staff across the region.

There are no current proposals for regional pay and there is a commitment to nationally agreed NHS pay guidelines known as Agenda for Change.

However, the paper does not pull any punches on what individual trusts must do to safeguard services.

A set of recommendations include a long list of "workforce cost reduction opportunities" which note the savings to the average trust.

A set of "optimisers" is also published which highlight how trusts can get best value for money within existing terms and conditions.

The document notes that more than 60 optimisers have been produced but adds: "none should be considered as straightforward to implement, as each represents either a loss in employee income or consequential changes in working practice."

The list includes suggestions on how consultants' pay may be controlled, study leave curtailed, new staff employed on different pay, terms and conditions and sickness absence subject to "very tight management" on a "daily basis". In terms of the cost reduction opportunities, reducing annual leave entitlement by two days is estimated at saving an average trust £1 million a year, while asking staff to work an extra hour a day for the same pay could mean an additional £2 million in the coffers.

A saving of £100,000 is estimated for trusts who ask staff to exchange a portion of their salary for more leave while the same amount could be pocketed if staff choose to voluntarily reduce their hours.

The SWC estimated that £1.4 million could be saved if a 1% uplift in salary is denied to all but the lowest paid workers.

Up to £800,000 could be saved if hours currently categorised as "unsocial" and therefore attracting extra pay were curtailed.

Mr Brown said the recommendations were things that boards must examine and decide whether it was worth pursuing.

He said that he knew some of the proposals would be controversial, however he added that the aim of the SWC was to guarantee the long term future of health trusts which, if they have obtained Foundation status, must break even financially.

"We know it is controversial and we know it is upsetting, but as responsible employers we have got to have this discussion.

"We could have it behind closed doors and not upset anyone, but we have instead had it publicly."

Mr Brown said many NHS workers had a holiday entitlement of six weeks plus eight bank holidays, which is more than private sector workers receive.

"If we say 'you reduce your holiday leave by a few days you improve your job security', is that an exchange people might consider?

"This isn't about taking away, this is about exchanging and thinking how we can work with staff and unions to look at this and not bury our heads in the sand and pretend challenges don't exist."

Mr Brown said he hoped the document answered fears expressed by unions that the SWC is a tool for circumnavigating nationally agreed NHS pay and conditions known as Agenda for Change.

"This is not about side stepping Agenda for Change," he said, adding that the report advocates working together with staff representatives to implement recently agreed national amendments to Agenda for Change.

The SWC was formed in June 2012 when 20 health trusts in the region each paid £10,000 to join up. Late last year, one of the trusts dropped out, but those who remain on board despite the outcry from unions include hospital trusts in North Devon, Plymouth, the Royal Devon and Exeter and the Royal Cornwall Hospital. Taunton and Somerset Hospital Trust are members, as are Yeovil District Hospital. The partnership trusts in Devon and in Somerset, which deal with mental health services, are also members.