- Conference
- 2024 National Health Care Service Group Conference
- Date
- 6 December 2023
- Decision
- Carried
In 2004 foundation trusts were introduced into the NHS. They remain part of the NHS and are generally larger trusts. When they were introduced, they came with more freedoms in how the hospitals were run and how they meet the demands on them. Over the past twenty years NHS trusts have been merging into mega-trusts, so that NHS trusts can gain foundation status and more often than not failing trusts can be rescued from financial difficulties.
In Eastern Region where NHS trusts are falling into financial difficulties, there has been an increase in a move to trust mergers which creates a ‘mega-trust’. We have seen it most recently in our region when on 1 April 2020 Mid and South Essex Foundation Trust was created from three existing NHS trusts.
Not only can these mergers be difficult for the staff working at the trust, but they can also usher in long periods of change management. Many new mega-trusts try to consolidate NHS functions and departments such as rationalising NHS services, IT, HR, clinical administration, payroll, etc, which all mean more change and job losses for our members.
It’s all very well that NHS England keeps pursuing these hospital mergers as an attempt to try and save some money, but after fourteen long years of Tory cuts, has anyone ever looked to see whether a bigger trust means a better trust and what the impact is on staff of these mega-trusts? It’s UNISON members that are on the frontline of cuts and restructures whenever one of these mergers take place. It is time for UNISON to review the role mega-trusts play in the NHS and look at whether they perform better or worse than other smaller trusts. If these mega -trusts are having a detrimental impact on staff then UNISON must make the argument against creating more of them if the overall performance of the trust decreases.
Conference calls on the Health Service Group Executive to:
1. Commission a report that looks at the role of mega trusts across the UK and the impact they have on staff. The report should:
a. compare data to see if mega-trusts perform worst than trusts that haven’t merged
b. include a league table of performance;
2. compare and contrast some of the key data we have from existing mega-trusts across the UK and look to see if they have lower staff morale (indicated from the NHS staff survey), greater levels of sickness absence, lower levels of staff retention rates, increase in the number of grievances and disciplinaries (employment issues), worse workforce and race equality standard data and look at training and development scores from the NHS staff survey;
3. review mega-trust finances and see if the creation of mega- trusts are causing more serious financial issues that are likely to have an impact on staff
Conference further calls on the Service Group Executive to:
4. use the report to create organising tools (leaflets, factsheets, bargaining guide) to help support branches that may be going through a merger or a proposed merger to make the case against it;
5. continue to use the “One Team” campaign to help promote the important NHS roles that are the backbone of the NHS and often the first roles to be consolidated when hospitals merge.