Q: Could you please provide details of the teams and services that will be included within the Unscheduled Care (UC) Portfolio?
A: All the team information is contained on the Trust Website
Q: To understand the rationale/decision for reducing 5 Ops managers into 4 posts within Urgent Care – service line is ever evolving with new initiatives and pathways so why reduce number of Ops Managers?
A: A review of all services and exploring the equality of all roles across the Division has been undertaken. Overall a 14.5% reduction in leadership workforce has been required. Within the UC portfolio a total of 13.8% leadership posts have been lost, which is below the Divisional average.
Q: Where are the positions that staff can select as preferences?
A: All posts within a persons current role can be preference during the process
Q: Where is the remaining post as this should be shared and not left for the remaining Ops Manager to slot into – they may not have the skill set or may actually wish to be aligned into that post?
A: All posts within a persons current role can be preference during the process
Q: Professional Leads – are they aligned just from a budget perspective or will they be actively supporting the service line?
A: All post holders will be expected to support the Divisional structure as per current/previous arrangements
Q: Head of AHPs – feel this needs to be a full time position given the expanding service and limited therapy leadership within our service line.
A: Thank you for your feedback the new Urgent Care Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: From an AHP perspective – within Urgent Care to support AHP development and promoting therapy would it not be best for Ops manager with AHP background to manage all therapists under Urgent Care Service line?
A: Whilst Operational Managers hold clinical qualifications, there if no pre-requisite for managers to manage within their professional backgrounds. The clinical leadership roles have been established to ensure clinical support can be gained from them. Changing this would disrupt clear lines of responsibility and accountability
Q: How would this work in practice? Where will the postholder line manager sit?
A: Following appointment to this role if it’s a singular person, a discussion would be had between the Division, the staff member and the Trust AHP leads to ascertain how this would be enacted and which portfolio the person would sit under. A singular role between CYP & Sefton services has been tried and tested previously.
Q: Could consideration be given to bringing the 3 adult B & B teams together in a single portfolio as this may fit better with change drivers outlined in proposal?
A: The Trust remains committed to working with partners in developing neighbourhood models of care. The models proposed should aid service line delivery and reduce bureaucracy, but a focus on Place also needs to remain a focus. Work streams will continue to bring in a standardised approach across the Division
Q: As Treatment room have the majority of competencies/pathways in the same way as DNs not sure this is a Specialist nursing service and these teams can cross support if needed. Which may offer opportunity to reduce Specialist Nurse portfolio and support neighbourhood models going forward if included in neighbourhood post portfolio and not Specialist?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Education Health Care planning – I understand supports Children and young people therefore can consideration be given to this being within CYP portfolios?
A: Thank you for your feedback this will be considered
Q: Specialist Nursing ops managers may be better to have set services rather than continuing to be Place based approach, to reduce duplication and need to involve all 3 8As to support standardisation and may not see benefits expected from proposed structure.
A: The Trust remains committed to working with partners in developing neighbourhood models of care. The models proposed should aid service line delivery and reduce bureaucracy, but a focus on Place also needs to remain a focus
Q: Group Out-of-Hours Services under one CSM for efficiency.
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Community adult service – the model says that there will be x 2 operational service manager posts for UTCs/WICs – divided as it currently is into Knowsley/Sefton & Liverpool. However the OSM team structure details also sent by Lee has Kirkby UTC with 3 Liverpool sites and then Smithdown WIC with 3 Sefton/Knowsley sites. Is this an error?
A: Thank you for raising this, this is an error. The current alignment of Liverpool and a separate alignment of Knowsley & Sefton will remain in place at the operational manager level
Q: Will the leadership structure in the tiers above be completed prior to being able to preference so staff/8as know who their SLT will be?
A: We will endeavour to build this into the timeline if possible
Q: Should Specialist Nursing ops managers have set services rather than a place-based approach?
A: The Trust remains committed to working with partners in developing neighbourhood models of care. The models proposed should aid service line delivery and reduce bureaucracy, but a focus on Place also needs to remain a focus
Q: Should Palliative Care be moved into the DN/CM line?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Should Lymphoedema be moved to the AHP portfolio?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Should the Diabetes team be closer to Dietetics and Podiatry?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Should Bladder & Bowel be with OT and Physio?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Would it be more efficient to group Community Matrons and Care Home Liaison Team under the same CSM?
A: The Trust remains committed to working with partners in developing neighbourhood models of care. The models proposed should aid service line delivery and reduce bureaucracy, but a focus on Place also needs to remain a focus
Q: Should Out-of-Hours Services (Knowsley and Sefton) be managed together under one CSM?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Move Paediatric Dietetics to CYP for better integration with family-centred care
A: Thank you for your feedback the new CYP & Wellbeing Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Is this a mistake? S & L 4.67 wte needs to stay in CYP.
A: This is an error and will rectified within the final model
Q: In CSM Liverpool we should have Bladder and Bowel CYP Liverpool (can’t see in any team) and Clinical Systems Team.
A: This is an error and will rectified within the final model
Q: In OPS Liverpool Post 1 – should be paediatric Liaison (currently in OPS Liverpool post 2).
A: Thank you for your feedback the new CYP & Wellbeing Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: In OPS Liverpool Post 2 – should be the EHCP, Bladder and Bowel CYP Liverpool and systems team.
A: Thank you for your feedback this will be considered
Q: Do we know the timescales for when changes will be considered and incorporated into a final model (if agreed)?
A: Consultation will close on 31 October. It is hoped that we can implement the new model for the 1 December 2025. The final model will be shared on 4 November 2025
Q: In the meantime, should we continue with the CYP & Sefton meeting structures?
A: Interim arrangements have been put into place and communicated
Q: Is the model a proposal, or a given? This wasn’t clear on Friday.
A: It is a proposal, we have received lot of feedback and suggestions which will change the proposed model
Q: In terms of stating post preference, how will this be decided?
A: The final process for preferencing and alignment will be confirmed in the consultation close meeting
Q: If another colleague ‘fancied a change’, and had more NHS experience than myself, etc…? How would that work?
A: The final process for preferencing and alignment will be confirmed in the consultation close meeting
Q: Could consideration be given for the pain management service and MSK to sit under wellbeing?
A: Thank you for your feedback the new CYP & Wellbeing Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: What does the inclusion of dental in the portfolio look like? Does it come with more ops provision? How many dental teams?
A: Dental has an 8a manager as part of the dental budget/ structure. Dental have 3 teams on DTL but operate as one service across Sefton, Knowsley and Liverpool
Q: Is there scope to consider leaving the services in the current structure with 2 Operational Managers rather than introducing a third to lessen any further impact on clinical teams?
A: Thank you for your feedback the new CYP & Wellbeing Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Would the admin arm in CYP have an 8a aligned?
A: Yes it does have this in the proposed structure
Q: How many 8a ‘admin leads’ are there and is the same OMS JD for all 8a regardless of which services they cover?
A: There will be 4 Service Improvement & Administration Managers within the new model. Yes each person will be operating under the same new JD
Q: Will there be two admin services – a CYP admin team/service and a Wellbeing admin team/service, or is the vision that these will be one CYP and wellbeing admin team/service?
A: The proposal is to only have one covering both areas
Q: At what point will this structure be clarified? At what point will the resources within this admin structure be confirmed to allow for CYP and Wellbeing leadership team to work on a proposed model to support admin going forward?
A: The final model is due to be clarified once the consultation process ends
Q: Can we please consider whether MSK/Pain can stay in Wellbeing portfolio – at least until April 2026?
A: Thank you for your feedback the new CYP & Wellbeing Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Can you please confirm the timeframe for resolving the structural queries in relation to the CYP services that are still sat within adults services - CYP dietetics, CYP podiatry and CYP orthotics.
Or if there is no current timeframe that might inform the structure, is there a task and finish group in place with key professionals from across these areas to propose some recommendations for moving forward.
A:Thank you for your feedback, a weekly meeting has been established to review all of the feedback and suggestions that are made as part of the consultation process. We may not be able to provide feedback until towards the end of consultation so that everything can be considered in totality but if we are able to we will endeavour to provide responses.
Q: Could we consider aligning these services under a single Operational Service Manager (OSM) and Head of AHP, while maintaining their neighbourhood focus?
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Could you provide clarity on the future of the 8a Professional Lead roles?
A: It is anticipated that the roles and function will remain unchanged, with the exception of the proposed new model for Podiatry.
Q: If the Advanced Clinical Practitioner (ACP) is expected to assume professional leadership responsibilities, how will their other pillars of practice—clinical, research, and education—be supported?
A: This is currently being reviewed and further details will be given at a later date
Q: Could you confirm whether a further restructure is anticipated at that time?
A: There are no future plans to review the Divisional Operational Management structure at this time. A review of corporate services may occur later in the new year
Q: Are there some thoughts on which portfolios the 8a profession lead roles will be aligned to? And also, which Head of AHP role will manage/supervise which role?
A: Discussion with postholder will be undertaken one the final model has been decided.
Q: What is the rationale for Sefton being aligned with equipment services and Liverpool with Mid-Mersey?
A: This is currently being reviewed and further details will be given at a later date
Q: Is the current alignment fixed or open for discussion/negotiation?
A: It is not fixed the purpose of consultation is to engage and receive feedback on the proposal and we welcome the feedback and suggestions received to date
Q: If SALT as a service line is successful, why not do the same for Podiatry and Dietetics?
A: The Speech & Language service is a very small service, which makes it really difficult to operate separately. The other AHP teams are larger and have not shown the same number of issues as S<
Q: Am I right in assuming that we will remain as Uni Professional and cover the whole of the division as we do currently?
A: Yes that is the case
Q: Can we have some clarity on the 4 roles within the proposed structure as there is no PDF detailing the posts as with the other 8a/8b/8C roles or is this simply who we will sit under for supervision etc.?
A: There is no planned changes proposed to the AHP Clinical lead roles, with the exception of which portfolio they sit under and which AHP lead they will report to
Q: Is the expectation that our ACP Podiatrist based in Mid will be expected to pick up the Podiatry prof lead role?
A: Yes that is the case. The Divisional Clinical Leadership team will work with the post holder to identify what skill and resources they have to undertake some of the functions of this role, If a gap is identified a further discussion divisionally will take place.
Q: Would you be open to the three of us developing a proposal that reflects this?
A: Yes we welcome feedback and alternative suggestions
Q: Paediatric Dietetics to CYP for better integration with family-centred care
A: Thank you for your feedback the new Community Adult Service Leadership team are currently reviewing this proposal and will provide their decisions on all proposal at the close down session
Q: Where should Dietetics Liverpool sit, given the size of Liverpool portfolios?
A: Liverpool Dietetics will sit under the portfolio of AHP's within Community Adult Services. They will be supported by the CSM for AHP within Liverpool
Q: Is a 0.5 WTE allocation sufficient for Head of AHP roles for both CYP and Urgent Care?
A: There is no plan to increase the number of Head of AHP's, therefore the proposal for equal split portfolio is to have 2 within Community adult services as over 80% of AHP's sit within the portfolio, leaving 1wte to cover both CYP & Urgent Care
Q: Who will be the line manager for the Head of AHP roles split across CYP and Urgent Care?
A: This is yet to be decided
Q: Will they be expected to attend both SLTs, governance meetings, safety huddles, and rapid reviews?
A: No there will be no requirement to at B31:B47 tend both senior leadership teams weekly, how this will work will be discussed with the post holder once appointed.
Q: I am extremely stretched so very thinly over all my teams depending on what the new structure looks like I will be preferring another option. How will the decision making happen of slotting in if someone doesn’t preference where they work now? Will any proforma’s be used based on experience/professional qualification? Who will make this decision, will it be service managers or HOO/above? Will preferences be discussed with CSM’s? or will it be a confidential process? Do we get a chance to explain our preferences and why, or is it just 3 options no narrative?
A: We are hopeful that if colleagues make 3 or more preferences we can align into one of their preferences. There will be a pro forma to complete and I think the suggestions that you have made in terms of being able to evidence skills and experience along with rational for choice is good so we will consider this. At the moment it will be a panel including Head of operations / quality and HR but CSM’s may also be involved. Once consultation has closed we can make the process for preferencing clear.
Q: In terms of the process of allocating staff to roles, is previous experience factored in? difficult for 80% to be applied to knowsley services for AHP and specialist teams. Who will decide of where staff are aligned?
A:Once the preferences are received the information will be reviewed to see if it is possible to assign people into one of their preferred posts. Individual discussions around preferences may be held at this stage.
A panel consisting of senior managers from both Operational and Quality along with HR representation will determine alignment into roles based upon preferences and the skills and experience of colleagues. It is important that colleagues are aligned to posts that will not compromise patient safety and stability particularly given the timing and winter pressures.
Q:Can you advise on reviewing the operational manager structure it does not detail the post WTE, I currently work 30 hours per week on a permanent contract with no wish to change. If I am being asked to add three preferences how will these hours be accommodated in other roles which are more or less than the 30 hours.
A:WTE have not been allocated to posts so that colleagues are not restricted with their preferences, current working hours will be accommodated in the roles within the structure.
Q: Please can I just ask as part of the consultation, would 8A Professional Leads for Dietetics, OT, PT and SLT have a 1:1 meeting and if so who would complete this?
A: The Heads of Operations and Associate Directors of Nursing are undertaking 1:1’s I can see you work across a number of places so you can link in with whichever Head of Operations you would like to have a 1:1 with.
Q:Has there been any update on where these operational clinical discussions re these paediatric therapies are taking place? It is difficult to preference without understanding where these decisions are up to.
A: These will take place over the coming weeks with SLT and then the final model will be shared at the consultation close down meeting, it is only after that that preferences will be asked for.
Q: The consultation just says ‘we will consider actions’ but doesn’t outline how the alignment decision will be made?
Be good to see almost a crib sheet so;
- If staff preference their current portfolio this will be the priority alignment
- If they don’t -what will be considered to make the decision?
A: If a portfolio in the new structure remains 80% or more of their current role and this is preferenced by the post holder then they will be aligned into it. We will include this on the preferencing form so that it is clear.
If that scenario does not exist or if the post holder wishes to move to another portfolio they will submit a minimum of 3 preferences. A panel of Senior Operational and Quality Colleagues along with HR support will then review the preferences against the remaining posts and determine alignment based upon skills and experience.
This is all subject to feedback during the consultation but that is the current proposed process which is in line with the org change policy.
Q: In previous organisational operational restructures, there has been a breakdown/ sharing of operational structures and the number of WTE and headcount within each portfolio so 8As and 8Bs can see what they are operationally responsible for, can this be shared as part of this process please.
A:Yes these will be appended to the consultation paper.
Q: Can I please ask, are all 8B posts budgeted to 1.0 WTE unless stated otherwise in the structure presented by Lee? How are flexible working requests taken into account during a preferencing process?
A: They are 1WTE unless otherwise specified, as part of the preferencing process you will be able to advise of any flexible working arrangements / part time hours that are in place and we will endeavour to honour these.
Q: Can the rationale be provided for what appears to be a split in Service Improvement & Change Manager’s posts in the new structure?
A: These post have were not reviewed prior to the formation of the Community Care Division. There has been an inequity of these roles, with some area's leading purely administration and not having service improvement support and other having service improvement but without administration leadership. Therefore the decision has been made to create joint roles moving forward
Q: Could you advise if there are any indicative timeframes for when this process is expected to conclude?
A: Consultation will close on 31st October. It is hoped that we can implement the new model for the 1st December 2025.
Q: Could you confirm whether the review will consider either: attaching additional portfolios to Operational Managers with disproportionately lower workloads, or removing portfolios from those with disproportionately higher workloads, to support a more equitable distribution across the division?
A: Yes the review has tried to consider equity within all roles across the Division.
Q: Could you confirm whether this funding and the role have been realigned elsewhere within the division?
A: No funding has been transferred to anywhere else within the Division. All posts /funding in scope have remained within the leadership structure. Reduction in posts has resulted in savings which has gone into the Divisional Cost Improvement Program
Q: Is there a template to show how decisions are made during the preferencing process?
A: Yes there will be a template to evidence decision making
Q: Appeal process – is there one? Is there a proforma that will be used for preferencing and will this be accessible as part of an appeal process?
A: There is no separate appeal process normal Trust policies will apply. Colleagues can have access to their own outcome sheet
Q: What is the process for alignment of preferences?
A: This is outlined in the consultation document and in other questions however the process will be shared in further detail at the consultation close meeting
Q: Is there an ask for budget and line management responsibilities to be extended further?
A: There is no increase to budget management or line management responsibilities, although the numbers of colleagues in a portfolio may be different, those responsibilities will not change
Q: Would normal TUPE arrangements apply or would anything else be put in place considering the consultation process has only just occurred?
A: This would need to be assessed but it would be unlikely that a CSM would be considered to be wholly or mainly aligned to one team given the portfolio's.
Q: What process is in place for this to be undertaken, can this process be shared for transparency to enable fair and equitable assigning?
A: This will be shared at the consultation close meeting
Q: How are these skills and experience being determined?
A: Further detail will be shared in the consultation close meeting
Q: Why is there an expectation to give a minimum of three options for preferred posts, especially when some staff may not have enough information about other positions?
A: Colleagues can continue to have discussions with senior managers and ask questions in order to inform their decision making
Q: Has there been any assessment of clinical safety regarding increased workloads for remaining staff after workforce reductions?
A: A full Quality and Equality Impact assessment has been conducted. It has been presented and accepted by senior leaders within the Trust, including deputy directors, exec directors and shared with the Trust Board
Q: Has the impact of cascading workload to direct reports, and its effect on clinical staff capacity and patient outcomes, been considered?
A: Yes, it is anticipated that the new structure will reduce duplication and bureaucracy, thus releasing management time. In addition, new technologies and data platforms are expected to release time for leaders.
Q: How will the selection process be applied in determining placements, and what happens if an individual is unsuccessful in their choices?
A: The aim is to align colleagues into one of their preferred posts if this is not possible then we will need to adopt an interview process.
Q: How will current ‘facilities time’ be accommodated within the new structure, and are there options for a reduced operational portfolio?
A: This will be an individual discussion but we will work with colleagues to ensure that facilities time can be accommodated
Q: Is the interim alignment to a new service line pre-empting the final outcome of the consultation?
A: No, it will be evident once the final structure is published that this has not been the case as there will be changes to the original proposed model
Q: What governance, support, and logistics will be in place for managing the interim structure, given current uncertainties?
A: Colleagues are retaining their current portfolio's in the interim structure as we felt this posed the least risk as the current governance structures remain available
Q: Is the Consultation for the whole Trust or just Community Care Division?
A: It is just for community care division
Q: Are the preferencing choices also outside of our division, i.e. education and training, workforce, temporary staffing?
A: The roles available for preferencing remain within the community division structure
Q: Were corporate divisions/mental health divisions part of the organisational restructure?
A: They were not as they have their own separate structures.
Q: If I preference a role and then it is decided it is not viable to maintain that service would normal TUPE arrangements apply or would anything else be put in place considering the consultation process has only just occurred?
A: Normal TUPE arrangements will apply however the test for TUPE is whether an individual is wholly or mainly aligned so it would depend on the post held.
Q: If I preference a service where there is also a non clinical staff member preferencing that portfolio – will they automatically get it if suitable for a non clinical ops manager as clinical I could cover a different portfolio?
A: A clinical qualification and or professional registration is not in the essential criteria of the person specification and this has been the case since 2022.
Q: Where would clinical support come from if you have clinical teams and the Clinical Service Manager is non clinical?
A: All areas will have dedicated clinical support attached through the clinical leadership model. It is not expected that CSM's will provide clinical support.