ICB Watch · NW NHS workforce evidence

Lancashire Teaching Hospitals (Acute · Lancashire & South Cumbria)

2026/27 — the year ahead

£60mthe savings this board must find in 2026/27.2026/27 Waste Reduction Programme target £60m, 5.7% of operating expenditure. NB the 25/26 WRP target was also £60m but delivered only £37m — this is a NEW 26/27 target, not a carry-over.
−360 WTEthe workforce reduction in its 2026/27 plan. iWhat does a “workforce reduction” mean? Not always people losing their jobs. Boards count in WTE — units of one full-time post — and the routes differ in who they touch. Cutting agency work: paid work lost, but no NHS post existed. Cutting bank shifts: extra shifts mostly worked by the trust’s own staff — a pay cut that never shows in post counts. Freezing vacancies: no one is dismissed, but the post and its future job go, and the work lands on those who remain. Deleting posts shrinks the establishment itself. Voluntary exits: MARS is a paid resignation without redundancy rights; voluntary redundancy is redundancy on volunteered terms. Compulsory redundancy is the rarest route — boards report it separately in their audited accounts.2026/27 plans to date — a minimum, by the deck’s own words (‘with more planned to achieve target’); follows 184 WTE already down under the WRP. The national payroll count is not usable for this trust (documented transfers).
Last year
Cut posts in 2025/26 — its figure counts all staff — substantive plus bank and agency — and still finished above its workforce plan. The trust’s own figures show ~117 WTE reduced by month 9 of a planned 1,056 — about 11% of the plan, with a quarter of the year left at that point. How they went about it: a voluntary exit (MARS) scheme ran and recruitment controls operated.
Who was cut
The national payroll count is not usable for this trust this year. Whole services — and their staff — moved between organisations during the year, so the count would mix those transfers with genuine cuts. Documented: One LSC shared corporate-services transfer (ELHT is host) (documented in our transfer audit)-08-07; LSC pathology single service transferred to LTH as lead provider on the first of April — donors named in the pack as ELHT, Blackpool and Morecambe Bay, moving under TUPE with roles and locations unchanged; documented (documented in our transfer audit)-08-09. The board’s own programme figures above are the usable evidence here.
Risks it carries
We hold 6 strategic risks from this board’s own register; the captured extract carries no numeric scores for this trust. Among them: “Delivery of the planned reduction in whole time equivalent workforce (NEW for 2026/27)”.
There is a risk that the Trust may not achieve the planned reduction in whole time equivalent (WTE) workforce for 2026/27. This is because of the requirement to increase performance, continued urgent and emergency care pressures and increasing patient acuity requiring workforce to be maintained or grow. This could result in an inability to achieve the waste reduction programme, inability to exit NHS Oversight Framework (NOF) segment 5 and further regulatory intervention.
This could result in a significant financial deficit, reduced resources for patient care, challenges in maintaining service delivery, insufficient income to cover operational costs, inability to exit NHS Oversight Framework (NOF) segment 5, further regulatory intervention, impact on staff experience, and reputational damage.
What staff say
27.4%say there are enough staff to do their jobtheir benchmark group: 31.3%
33.3%often or always feel burnt outtheir benchmark group: 32.4%
34.1%often think about leavingtheir benchmark group: 29.9%
NHS Staff Survey 2025 · compared with similar trusts iNHS Staff Survey 2025. The comparison figure is the average of the trust’s own “benchmark group” — the set of similar trusts NHS England compares it with.
Why the cuts?
The trust’s own papers state why it is reducing its workforce: its savings programme (what the NHS calls a cost improvement programme, CIP). iThese are the reasons the trust itself gives for its workforce reduction, coded from its public board papers. Wider pressures — on services, waiting times or safety — appear under “Risks it carries”, from the board’s own risk register.
On the record — the board’s own papers & where every figure comes from
  • LTH 2025/26 PLANNED HEADCOUNT REDUCTION — 1,056 WTE total (board pack 3 Apr 2025) Public Board of Directors 3 April 2025 · p.87
  • LTH 2025/26 IDENTIFIED schemes — 442 WTE reduction backed by Waste Reduction Programme (3 Apr 2025) Public Board of Directors 3 April 2025 · p.87
  • LTH 2025/26 UNIDENTIFIED schemes — 614 WTE reductions assigned to new Turnaround Director (3 Apr 2025) Public Board of Directors 3 April 2025 · p.87
  • Lancashire Teaching Hospitals cites a funding gap for MARS schemes in its workforce-reduction BAF risk LTH BAF Full Report April 2026 — PR-WTE-2627 (Workforce reduction BAF risk) + Finance & Performance Committee narrative · p.51
  • LTH caps recruitment at 20 WTE approvals per month via a Vacancy Control Panel. LTH Board Pack — April 2026 · p.97
Sources: the trust’s own board papers (cited above) · NHS England workforce statistics (Apr→Apr, our arithmetic) · NHS Staff Survey 2025 · every figure is traceable to the evidence ledger on the audit twin of this page
Plain-English key
WTE / FTEtwo names for the same measure — one full-time post’s worth of paid staff time (two half-time staff count as one). It is a unit of time, not a count of people: a reduction of 100 WTE can mean fewer people, fewer hours, or fewer bank and agency shifts, and is usually a mix. Boards plan and report in WTE across all staff — permanent, bank and agency together — and so does this card, which says which of those a figure counts. Boards write WTE (“whole-time equivalent”); the national statistics write FTE (“full-time equivalent”).
CIP“cost improvement programme” — the NHS term for a savings plan.
Deficitspending more than the money coming in. A trust whose plan is a deficit is planning to end the year in the red by that amount.
MARS“mutually agreed resignation scheme” — a voluntary paid-exit scheme.
Establishmentthe number of funded posts a trust plans to employ — its budgeted staffing level — whether or not each post is filled. Removing a vacancy from the establishment cuts the planned staffing level without anyone losing a job.
Substantivepermanently employed staff, as opposed to bank or agency staff.
Benchmark groupthe set of similar trusts NHS England compares each trust with in the staff survey.