More than 80% of staff working in strategic health authorities and primary care trusts in England expect to lose their jobs or are uncertain about the future, according to an exclusive poll by EHI Primary Care.

Almost 40% of the 400 respondents to the survey believe they will be made redundant or lose their contract as a result of the white paper, ‘Equity and Excellence: Liberating the NHS’, and a further 46% do not know what will happen to them.

Many expect to know their fate within the next three to six months, with the demand for the health service to make £20 billion efficiency savings over the next four years having a further impact.

One respondent wrote: “We need to make 30% to 40% management cost savings in year so we expect redundancies to be announced soon.”

EHI Primary Care ran a poll to assess the impact of the white paper over the summer. It was completed by 403 NHS staff working for SHAs, PCTs and health informatics services, in jobs covering IT (65%), general management (11%) and commissioning (16%).

Three quarters of those completing the survey had worked for the NHS for more than five years, including a fifth who had worked for the health service for more than 20 years. Almost half were department heads or senior managers.

The vast majority of respondents (86%) said morale had declined since the government outlined its plans to scrap commissioning bodies and transfer their functions to a new NHS Commissioning Board and GP commissioning consortia.

Of these, most (58%) said that morale had declined greatly and 18% reported that morale had fallen slightly. No respondent reported that it had increased significantly.

Free text comments included: “They are huge cuts to staff numbers, driving morale through the floor” and “I am involved in IT and rolling out new systems to PCTs, so the future is very bleak.”

More than 70% of survey respondents said they would like to be working for the NHS in two to three years’ time. However, although 24% expected to achieve this by working for a GP commissioning consortium, only 17% wanted to work for one.

One respondent wrote: “It is very difficult to see where services such as IT will sit in an area with multiple GP consortia.” Although another said: “I am in a privileged position, heading up information team that supports practice based commissioning.

“I am increasingly excited as new GP commissioners only want information that helps them to improve the patient experience, rather than satisfy the reporting of pointless process based targets that make little difference to patient care.”

More than one in ten respondents (13%) expected to be working for the private sector in healthcare, while 7% believed their future job would lie outside healthcare.

Asked to predict the impact of the white paper on colleagues, 47% thought many would lose their jobs and leave healthcare, while 25% believed colleagues would find new jobs in the health service.

Unsurprisingly, most respondents were pessimistic about the impact of the white paper on IT skills in the NHS, with 43% thinking it would lead to a big loss of IT skills and 22% that it would lead to some loss of skills.

Only one in 20 of those completing the survey believed the white paper would lead to an increase in skills because of new private sector and contract opportunities.

One respondent said: “The good people at the PCT are job-hunting, so by 2013 we’ll probably already have declined in performance.”

NHS chief executive Sir David Nicholson has admitted that many NHS staff will find the latest round of reorganisation difficult and that a “significant” number will lose their jobs.

The day after the white paper was published, he promised that “every” member of staff working in an SHA or PCT would have the chance to discuss their future with a line manager by the end of September.

However, the survey, which was conducted between 20 August and 17 September, found that just 26% of respondents had had an interview with their line manager, although a further 36% expected to do so.

Comments submitted by respondents to the survey echoed the quantitative findings. However, a few were more positive. One said: “I take no news as good news. We are waiting for the IT strategy to come out before panicking.”

Link: Read more in Fiona’s analysis, Radio times