The Dismissal of over Ten Thousand NHS Staff via ‘Some Other Substantial Reason’

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 17 February 2019

The worst organisations in the NHS are managed ineptly, and with an immature intolerance for staff who swim against the current. This may be accompanied by arbitrary, excessively harsh or even manufactured disciplinary process:

Waste Industry: Abuses of the NHS disciplinary process

Public resources are wasted by sacking unwanted individuals, be they whistleblowers, trade union activists or anyone else who does not conform sufficiently, even if they are perfectly capable and have not misconducted themselves. The sacking takes place under the insidious category of dismissals for ‘Some Other Substantial Reason’, (SOSR) such as a purported breakdown of relationships.

Such breakdowns can be easy to engineer, with deliberate employer provocation. For example in whistleblower cases, the original concerns raised soon become buried under a hail of grievances, counter grievances and deliberately unfair procedures that generate more conflict. Such wars are waged with calculated malice by some employers, who may call in the lawyers to steer strategy long before any formal process, and before the employee realises that they are being managed out.  When such cases arrive at the Employment Tribunal, they are complicated, hard to fight and prohibitively expensive for the employee. The courts often find contributory fault by the employee without sufficiently recognising the employer provocation.

An FOI disclosure of 15 February 2019 by NHS Digital revealed that between April 2010 and September 2018, the NHS has sacked 10,604 staff under SOSR:

 

NHS Hospital and Community Health Services (HCHS): Incidents of HCHS staff with a recorded reason for leaving of Dismissal – Some Other Substantial Reason, in NHS Trusts, CCGs, Support Organisations and Central Bodies in England, 30 April 2010 to 30 September 2018, headcount
Year	Headcount
April 2010 to March 2011	1,649
April 2011 to March 2012	1,453
April 2012 to March 2013	1,235
April 2013 to March 2014	1,151
April 2014 to March 2015	1,164
April 2015 to March 2016	1,222
April 2016 to March 2017	1,232
April 2017 to March 2018	1,231
April 2018 to September 2018	267
TOTAL	10,604
Source: NHS Digital NHS Hospital & Community Health Service (HCHS) workforce statistics.

 

The number of NHS SOSR sackings over an eight year period, breaks down by region as follows, with the North West, West Midlands and East of England regions topping the pops:

REGION	DISMISSALS VIA SOSR
Health Education North West	1,557
Health Education West Midlands	1,152
Health Education East of England	1,117
Health Education Yorkshire and the Humber	894
Health Education North Central and East London	813
Health Education East Midlands	760
Health Education South West	699
Health Education Kent, Surrey and Sussex	650
Health Education South London	631
Health Education Wessex	430
Health Education North West London	378
Health Education North East	366
Health Education Thames Valley	346
TOTAL	9,793

 

The full list of SOSR sackings for each NHS trust is provided in the appendix.

The top twenty NHS trusts who sacked the most staff under SOSR in these eight years is as follows:

 

Organisation name	Org code	Headcount: Dismissal, Some Other Substantial Reason	SIZE OF TRUST
Nottingham University Hospitals NHS Trust	RX1	348	Large (more than 10,000 staff)
Leeds Teaching Hospitals NHS Trust	RR8	233	Large (more than 10,000 staff)
Barts Health NHS Trust	R1H	170	Large (more than 10,000 staff)
St George’s University Hospitals NHS Foundation Trust	RJ7	162	Large (more than 10,000 staff)
University College London Hospitals NHS Foundation Trust	RRV	155	Medium (between 5,000 and 10,000 staff)
Oxford University Hospitals NHS Foundation Trust	RTH	132	Large (more than 10,000 staff)
Pennine Acute Hospitals NHS Trust	RW6	132	Medium (between 5,000 and 10,000 staff)
University Hospital Southampton NHS Foundation Trust	RHM	129	Large (more than 10,000 staff)
Heart of England NHS Foundation Trust	RR1	115	Large (more than 10,000 staff)
East of England Ambulance Service NHS Trust	RYC	106	Medium (between 5,000 and 10,000 staff)
York Teaching Hospital NHS Foundation Trust	RCB	103	Large (more than 10,000 staff)
Wirral University Teaching Hospital NHS Foundation Trust	RBL	100	Medium (between 5,000 and 10,000 staff)
Aintree University Hospital NHS Foundation Trust	REM	96	Small (up to 5,000 staff)
Birmingham and Solihull Mental Health NHS Foundation Trust	RXT	96	Small (up to 5,000 staff)
Guy’s and St Thomas’ NHS Foundation Trust	RJ1	91	Large (more than 10,000 staff)
Princess Alexandra Hospital NHS Trust	RQW	81	Small (up to 5,000 staff)
Royal Free London NHS Foundation Trust	RAL	81	Large (more than 10,000 staff)
Stockport NHS Foundation Trust	RWJ	81	Medium (between 5,000 and 10,000 staff)
South Essex Partnership University NHS Foundation Trust	RWN	80	Medium (between 5,000 and 10,000 staff)
Royal Wolverhampton NHS Trust	RL4	78	Medium (between 5,000 and 10,000 staff)

 

Some trusts rated as ‘Outstanding’ by the CQC did their bit to push up the SOSR stats. In the clear lead was Birmingham Women’s and Children’s NHS Foundation Trust, whose CEO regularly makes public statements about the importance of staff engagement and positive culture:

Dismissals via SOSR between 1 April 2010 and 31 March 2018 by NHS trusts currently rated as ‘Outstanding’:

NHS TRUST	DISMISSALS VIA SOSR	SIZE OF TRUST
Birmingham Women’s and Children’s NHS Foundation Trust	129	Large (more than 10,000 staff)
Christie NHS Foundation Trust	64	Small (up to 5,000 staff)
Clatterbridge Cancer Centre NHS Foundation Trust	63	Medium (between 5,000 and 10,000 staff)
East London NHS Foundation Trust	52	Medium (between 5,000 and 10,000 staff)
Frimley Health NHS Foundation Trust	50	Small (up to 5,000 staff)
Lincolnshire Community Health Services NHS Trust	39	Medium (between 5,000 and 10,000 staff)
Newcastle Upon Tyne Hospitals NHS Foundation Trust	34	Medium (between 5,000 and 10,000 staff)
Northamptonshire Healthcare NHS Foundation Trust	29	Small (up to 5,000 staff)
Northumbria Healthcare NHS Foundation Trust	28	Small (up to 5,000 staff)
Northumberland, Tyne and Wear NHS Foundation Trust	28	Small (up to 5,000 staff)
Royal Marsden NHS Foundation Trust	24	Small (up to 5,000 staff)
Salford Royal NHS Foundation Trust	22	Small (up to 5,000 staff)
Surrey and Sussex Healthcare NHS Trust	15	Small (up to 5,000 staff)
Walton Centre NHS Foundation Trust	7	Small (up to 5,000 staff)
Western Sussex Hospitals NHS Foundation Trust	6	Small (up to 5,000 staff)
West Suffolk NHS Foundation Trust	6	Small (up to 5,000 staff)
West Midlands Ambulance Service NHS Foundation Trust	6	Small (up to 5,000 staff)
Source: NHS Digital NHS Hospital & Community Health Service (HCHS) workforce statistics.
Size of trust by number of employees sourced from National Guardian’s published data

 

National NHS bodies also contributed to the SOSR trail of devastation. Notably, NHS Blood and Transplant, the former billet of the new CQC chief executive Ian Trenholm, had its fair share of SOSR sackings:

DISMISSALS VIA SOSR 1 APRIL 2010 to 31 MARCH 2018
NATIONAL NHS BODY	DISMISSALS VIA SOSR
NHS Direct NHS Trust	359
NHS Blood and Transplant	59
NHS Business Services Authority	36
NHS Property Services Limited	28
Public Health England	13
NHS England	11
NHS Professionals Ltd	6
NHS Digital	5
NHS South, Central and West Commissioning Support Unit	5
Health Education England	4
NHS North of England Commissioning Support Unit	4
National Institute for Health and Care Excellence	3
NHS Arden and Greater East Midlands Commissioning Support Unit	3
NHS Midlands and Lancashire Commissioning Support Unit	3
NHS Institute For Innovation and Improvement	2
Northern Deanery	2
NHS South East Commissioning Support Unit	1

 

Training and developing NHS staff costs millions. They are a precious resource paid for by the public. It is staggering incompetence and maladministration to discard such resource for petty and or self-serving reasons. Even where there is genuine and insoluble breakdown of the employment relationship, the NHS as a vast employer should be able to manage redeployment to avoid such waste.

 

RELATED ITEMS

The unfair sacking of Andrew Smith, NHS whistleblower and trade union representative. A heady cocktail of tainted ingredients. Or how CQC, NHS Improvement & Mid Essex Hospital Services NHS Trust worked together on FPPR.

Mr Tristan Reuser surgeon & GMC. Update on GMC, whistleblowing and implementation of the Hooper recommendations

Dr Kevin Beatt NHS whistleblower & the negligent GMC

Whistleblowing in the NHS isn’t fixed yet, and this leaves patients exposed. An overview of unfinished policy business.

What could a new whistleblowing law look like? A discussion document

 

APPENDIX

Incidents of NHS trust staff with a recorded reason for leaving of Dismissal – Some Other Substantial Reason by organisation, England 30 April 2010 to 31 March 2018, headcount

Source: NHS Digital NHS Hospital & Community Health Service (HCHS) workforce statistics. Size of trust by number of employees sourced from National Guardian’s published data.

NHS Trusts are listed in descending order, starting with those that have sacked the most staff under SOSR.

Organisation name	Org code	Headcount: Dismissal, Some Other Substantial Reason	SIZE OF TRUST
Nottingham University Hospitals NHS Trust	RX1	348	Large (more than 10,000 staff)
Leeds Teaching Hospitals NHS Trust	RR8	233	Large (more than 10,000 staff)
Barts Health NHS Trust	R1H	170	Large (more than 10,000 staff)
St George’s University Hospitals NHS Foundation Trust	RJ7	162	Large (more than 10,000 staff)
University College London Hospitals NHS Foundation Trust	RRV	155	Medium (between 5,000 and 10,000 staff)
Oxford University Hospitals NHS Foundation Trust	RTH	132	Large (more than 10,000 staff)
Pennine Acute Hospitals NHS Trust	RW6	132	Medium (between 5,000 and 10,000 staff)
University Hospital Southampton NHS Foundation Trust	RHM	129	Large (more than 10,000 staff)
Heart of England NHS Foundation Trust	RR1	115	Large (more than 10,000 staff)
East of England Ambulance Service NHS Trust	RYC	106	Medium (between 5,000 and 10,000 staff)
York Teaching Hospital NHS Foundation Trust	RCB	103	Large (more than 10,000 staff)
Wirral University Teaching Hospital NHS Foundation Trust	RBL	100	Medium (between 5,000 and 10,000 staff)
Aintree University Hospital NHS Foundation Trust	REM	96	Small (up to 5,000 staff)
Birmingham and Solihull Mental Health NHS Foundation Trust	RXT	96	Small (up to 5,000 staff)
Guy’s and St Thomas’ NHS Foundation Trust	RJ1	91	Large (more than 10,000 staff)
Princess Alexandra Hospital NHS Trust	RQW	81	Small (up to 5,000 staff)
Royal Free London NHS Foundation Trust	RAL	81	Large (more than 10,000 staff)
Stockport NHS Foundation Trust	RWJ	81	Medium (between 5,000 and 10,000 staff)
South Essex Partnership University NHS Foundation Trust	RWN	80	Medium (between 5,000 and 10,000 staff)
Royal Wolverhampton NHS Trust	RL4	78	Medium (between 5,000 and 10,000 staff)
Sandwell and West Birmingham Hospitals NHS Trust	RXK	75	Medium (between 5,000 and 10,000 staff)
South Western Ambulance Service NHS Foundation Trust	RYF	71	Medium (between 5,000 and 10,000 staff)
Mid Yorkshire Hospitals NHS Trust	RXF	70	Medium (between 5,000 and 10,000 staff)
University Hospitals of Leicester NHS Trust	RWE	69	Large (more than 10,000 staff)
Gloucestershire Hospitals NHS Foundation Trust	RTE	69	Medium (between 5,000 and 10,000 staff)
Imperial College Healthcare NHS Trust	RYJ	68	Large (more than 10,000 staff)
Tees, Esk and Wear Valleys NHS Foundation Trust	RX3	66	Medium (between 5,000 and 10,000 staff)
South East Coast Ambulance Service NHS Foundation Trust	RYD	65	Small (up to 5,000 staff)
South London and Maudsley NHS Foundation Trust	RV5	64	Small (up to 5,000 staff)
Central and North West London NHS Foundation Trust	RV3	63	Medium (between 5,000 and 10,000 staff)
East London NHS Foundation Trust	RWK	63	Medium (between 5,000 and 10,000 staff)
Christie NHS Foundation Trust	RBV	63	Small (up to 5,000 staff)
Coventry and Warwickshire Partnership NHS Trust	RYG	63	Small (up to 5,000 staff)
University Hospitals Bristol NHS Foundation Trust	RA7	63	Large (more than 10,000 staff)
North Middlesex University Hospital NHS Trust	RAP	61	Small (up to 5,000 staff)
University Hospitals of North Midlands NHS Trust	RJE	61	Large (more than 10,000 staff)
East Sussex Healthcare NHS Trust	RXC	60	Medium (between 5,000 and 10,000 staff)
Royal Cornwall Hospitals NHS Trust	REF	60	Medium (between 5,000 and 10,000 staff)
King’s College Hospital NHS Foundation Trust	RJZ	59	Large (more than 10,000 staff)
Cambridgeshire Community Services NHS Trust	RYV	58	Small (up to 5,000 staff)
Southern Health NHS Foundation Trust	RW1	58	Medium (between 5,000 and 10,000 staff)
Norfolk and Suffolk NHS Foundation Trust	RMY	56	Small (up to 5,000 staff)
Cambridgeshire and Peterborough NHS Foundation Trust	RT1	55	Small (up to 5,000 staff)
South Central Ambulance Service NHS Foundation Trust	RYE	54	Small (up to 5,000 staff)
County Durham and Darlington NHS Foundation Trust	RXP	54	Medium (between 5,000 and 10,000 staff)
Shrewsbury and Telford Hospital NHS Trust	RXW	54	Medium (between 5,000 and 10,000 staff)
Taunton and Somerset NHS Foundation Trust	RBA	54	Small (up to 5,000 staff)
North Tees and Hartlepool NHS Foundation Trust	RVW	53	Medium (between 5,000 and 10,000 staff)
West Midlands Ambulance Service NHS Foundation Trust	RYA	53	Medium (between 5,000 and 10,000 staff)
South Tees Hospitals NHS Foundation Trust	RTR	52	Medium (between 5,000 and 10,000 staff)
North Bristol NHS Trust	RVJ	52	Medium (between 5,000 and 10,000 staff)
Nottinghamshire Healthcare NHS Foundation Trust	RHA	51	Medium (between 5,000 and 10,000 staff)
Lewisham and Greenwich NHS Trust	RJ2	51	Medium (between 5,000 and 10,000 staff)
Medway NHS Foundation Trust	RPA	51	Small (up to 5,000 staff)
Western Sussex Hospitals NHS Foundation Trust	RYR	51	Medium (between 5,000 and 10,000 staff)
Lancashire Teaching Hospitals NHS Foundation Trust	RXN	51	Medium (between 5,000 and 10,000 staff)
Central Manchester University Hospitals NHS Foundation Trust	RW3	50	Large (more than 10,000 staff)
North West Boroughs Healthcare NHS Foundation Trust	RTV	50	Small (up to 5,000 staff)
Royal Berkshire NHS Foundation Trust	RHW	48	Small (up to 5,000 staff)
Countess of Chester Hospital NHS Foundation Trust	RJR	48	Small (up to 5,000 staff)
Yorkshire Ambulance Service NHS Trust	RX8	47	Medium (between 5,000 and 10,000 staff)
Dorset Healthcare University NHS Foundation Trust	RDY	47	Medium (between 5,000 and 10,000 staff)
Mersey Care NHS Foundation Trust	RW4	47	Medium (between 5,000 and 10,000 staff)
Warrington and Halton Hospitals NHS Foundation Trust	RWW	47	Small (up to 5,000 staff)
Basildon and Thurrock University Hospitals NHS Foundation Trust	RDD	46	Medium (between 5,000 and 10,000 staff)
South West London and St George’s Mental Health NHS Trust	RQY	46	Small (up to 5,000 staff)
Greater Manchester Mental Health NHS Foundation Trust	RXV	46	Small (up to 5,000 staff)
Mid Cheshire Hospitals NHS Foundation Trust	RBT	46	Small (up to 5,000 staff)
Staffordshire and Stoke on Trent Partnership NHS Trust	R1E	46	Medium (between 5,000 and 10,000 staff)
Norfolk and Norwich University Hospitals NHS Foundation Trust	RM1	45	Medium (between 5,000 and 10,000 staff)
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust	RP5	45	Medium (between 5,000 and 10,000 staff)
Brighton and Sussex University Hospitals NHS Trust	RXH	45	Medium (between 5,000 and 10,000 staff)
Northern Lincolnshire and Goole NHS Foundation Trust	RJL	44	Medium (between 5,000 and 10,000 staff)
London Ambulance Service NHS Trust	RRU	44	Medium (between 5,000 and 10,000 staff)
Frimley Health NHS Foundation Trust	RDU	44	Medium (between 5,000 and 10,000 staff)
University Hospitals Birmingham NHS Foundation Trust	RRK	44	Medium (between 5,000 and 10,000 staff)
Great Western Hospitals NHS Foundation Trust	RN3	44	Medium (between 5,000 and 10,000 staff)
North West Anglia NHS Foundation Trust	RGN	43	Medium (between 5,000 and 10,000 staff)
Hillingdon Hospitals NHS Foundation Trust	RAS	43	Small (up to 5,000 staff)
Cheshire and Wirral Partnership NHS Foundation Trust	RXA	43	Small (up to 5,000 staff)
Yeovil District Hospital NHS Foundation Trust	RA4	43	Small (up to 5,000 staff)
East Midlands Ambulance Service NHS Trust	RX9	42	Small (up to 5,000 staff)
Northampton General Hospital NHS Trust	RNS	42	Medium (between 5,000 and 10,000 staff)
Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust	RCX	42	Small (up to 5,000 staff)
Buckinghamshire Healthcare NHS Trust	RXQ	42	Medium (between 5,000 and 10,000 staff)
Tameside and Glossop Integrated Care NHS Foundation Trust	RMP	42	Small (up to 5,000 staff)
Mid Essex Hospital Services NHS Trust	RQ8	41	Medium (between 5,000 and 10,000 staff)
West Hertfordshire Hospitals NHS Trust	RWG	41	Small (up to 5,000 staff)
St Helens and Knowsley Teaching Hospitals NHS Trust	RBN	41	Small (up to 5,000 staff)
Bolton NHS Foundation Trust	RMC	40	Small (up to 5,000 staff)
Salford Royal NHS Foundation Trust	RM3	40	Medium (between 5,000 and 10,000 staff)
Birmingham Women’s and Children’s NHS Foundation Trust	RQ3	40	Medium (between 5,000 and 10,000 staff)
Worcestershire Acute Hospitals NHS Trust	RWP	40	Medium (between 5,000 and 10,000 staff)
Barking, Havering and Redbridge University Hospitals NHS Trust	RF4	39	Medium (between 5,000 and 10,000 staff)
Barnet, Enfield and Haringey Mental Health NHS Trust	RRP	39	Small (up to 5,000 staff)
Burton Hospitals NHS Foundation Trust	RJF	39	Small (up to 5,000 staff)
Walsall Healthcare NHS Trust	RBK	39	Large (more than 10,000 staff)
East Suffolk and North Essex NHS Foundation Trust	RDE	37	Medium (between 5,000 and 10,000 staff)
West London Mental Health NHS Trust	RKL	37	Small (up to 5,000 staff)
Croydon Health Services NHS Trust	RJ6	37	Small (up to 5,000 staff)
Surrey and Sussex Healthcare NHS Trust	RTP	37	Small (up to 5,000 staff)
University Hospitals of Morecambe Bay NHS Foundation Trust	RTX	37	Medium (between 5,000 and 10,000 staff)
Midlands Partnership NHS Foundation Trust	RRE	37	Medium (between 5,000 and 10,000 staff)
Hinchingbrooke Health Care NHS Trust	RQQ	36	Small (up to 5,000 staff)
Homerton University Hospital NHS Foundation Trust	RQX	36	Small (up to 5,000 staff)
Kent Community Health NHS Foundation Trust	RYY	36	Small (up to 5,000 staff)
East Lancashire Hospitals NHS Trust	RXR	36	Medium (between 5,000 and 10,000 staff)
Cambridge University Hospitals NHS Foundation Trust	RGT	35	Large (more than 10,000 staff)
Northumbria Healthcare NHS Foundation Trust	RTF	35	Large (more than 10,000 staff)
Royal Liverpool and Broadgreen University Hospitals NHS Trust	RQ6	35	Medium (between 5,000 and 10,000 staff)
Bedford Hospital NHS Trust	RC1	34	Small (up to 5,000 staff)
Sussex Partnership NHS Foundation Trust	RX2	34	Small (up to 5,000 staff)
Pennine Care NHS Foundation Trust	RT2	34	Medium (between 5,000 and 10,000 staff)
Dudley Group NHS Foundation Trust	RNA	34	Medium (between 5,000 and 10,000 staff)
Portsmouth Hospitals NHS Trust	RHU	33	Medium (between 5,000 and 10,000 staff)
South London Healthcare NHS Trust	RYQ	33	Medium (between 5,000 and 10,000 staff)
North East London NHS Foundation Trust	RAT	33	Medium (between 5,000 and 10,000 staff)
University Hospital of South Manchester NHS Foundation Trust	RM2	33	Medium (between 5,000 and 10,000 staff)
Avon and Wiltshire Mental Health Partnership NHS Trust	RVN	33	Small (up to 5,000 staff)
East and North Hertfordshire NHS Trust	RWH	32	Medium (between 5,000 and 10,000 staff)
Rotherham Doncaster and South Humber NHS Foundation Trust	RXE	32	Small (up to 5,000 staff)
London North West University Healthcare NHS Trust	R1K	32	Medium (between 5,000 and 10,000 staff)
Whittington Health NHS Trust	RKE	32	Small (up to 5,000 staff)
Kent and Medway NHS and Social Care Partnership Trust	RXY	32	Small (up to 5,000 staff)
Kettering General Hospital NHS Foundation Trust	RNQ	31	Small (up to 5,000 staff)
Maidstone and Tunbridge Wells NHS Trust	RWF	31	Medium (between 5,000 and 10,000 staff)
United Lincolnshire Hospitals NHS Trust	RWD	30	Medium (between 5,000 and 10,000 staff)
Lincolnshire Partnership NHS Foundation Trust	RP7	29	Small (up to 5,000 staff)
South West Yorkshire Partnership NHS Foundation Trust	RXG	29	Small (up to 5,000 staff)
Chelsea and Westminster Hospital NHS Foundation Trust	RQM	29	Small (up to 5,000 staff)
Ipswich Hospital NHS Trust	RGQ	28	Small (up to 5,000 staff)
Salisbury NHS Foundation Trust	RNZ	28	Small (up to 5,000 staff)
Royal Surrey County Hospital NHS Foundation Trust	RA2	28	Small (up to 5,000 staff)
Birmingham Community Healthcare NHS Foundation Trust	RYW	28	Small (up to 5,000 staff)
Royal Devon and Exeter NHS Foundation Trust	RH8	28	Medium (between 5,000 and 10,000 staff)
Torbay and South Devon NHS Foundation Trust	RA9	28	Medium (between 5,000 and 10,000 staff)
Southend University Hospital NHS Foundation Trust	RAJ	27	Small (up to 5,000 staff)
Leeds Community Healthcare NHS Trust	RY6	27	Small (up to 5,000 staff)
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust	RDZ	27	Small (up to 5,000 staff)
Surrey and Borders Partnership NHS Foundation Trust	RXX	27	Small (up to 5,000 staff)
Southport and Ormskirk Hospital NHS Trust	RVY	27	Small (up to 5,000 staff)
Northern Devon Healthcare NHS Trust	RBZ	27	Small (up to 5,000 staff)
Leicestershire Partnership NHS Trust	RT5	26	Medium (between 5,000 and 10,000 staff)
Norfolk Community Health and Care NHS Trust	RY3	26	Small (up to 5,000 staff)
Epsom and St Helier University Hospitals NHS Trust	RVR	26	Small (up to 5,000 staff)
East Kent Hospitals University NHS Foundation Trust	RVV	26	Medium (between 5,000 and 10,000 staff)
East Cheshire NHS Trust	RJN	26	Small (up to 5,000 staff)
Royal United Hospitals Bath NHS Foundation Trust	RD1	26	Medium (between 5,000 and 10,000 staff)
West Suffolk NHS Foundation Trust	RGR	25	Small (up to 5,000 staff)
Rotherham NHS Foundation Trust	RFR	25	Small (up to 5,000 staff)
Harrogate and District NHS Foundation Trust	RCD	24	Small (up to 5,000 staff)
Dartford and Gravesham NHS Trust	RN7	24	Small (up to 5,000 staff)
Sussex Community NHS Foundation Trust	RDR	24	Medium (between 5,000 and 10,000 staff)
City Hospitals Sunderland NHS Foundation Trust	RLN	24	Small (up to 5,000 staff)
North East Ambulance Service NHS Foundation Trust	RX6	24	Small (up to 5,000 staff)
North Staffordshire Combined Healthcare NHS Trust	RLY	24	Small (up to 5,000 staff)
Worcestershire Health and Care NHS Trust	R1A	24	Small (up to 5,000 staff)
University Hospitals of Derby and Burton NHS Foundation Trust	RTG	23	Large (more than 10,000 staff)
Sheffield Children’s NHS Foundation Trust	RCU	23	Small (up to 5,000 staff)
Hampshire Hospitals NHS Foundation Trust	RN5	23	Medium (between 5,000 and 10,000 staff)
Kingston Hospital NHS Foundation Trust	RAX	23	Small (up to 5,000 staff)
North West Ambulance Service NHS Trust	RX7	23	Medium (between 5,000 and 10,000 staff)
Hertfordshire Partnership University NHS Foundation Trust	RWR	22	Small (up to 5,000 staff)
Humber Teaching NHS Foundation Trust	RV9	22	Small (up to 5,000 staff)
Berkshire Healthcare NHS Foundation Trust	RWX	22	Small (up to 5,000 staff)
Milton Keynes University Hospital NHS Foundation Trust	RD8	22	Small (up to 5,000 staff)
Alder Hey Children’s NHS Foundation Trust	RBS	22	Small (up to 5,000 staff)
Dorset County Hospital NHS Foundation Trust	RBD	21	Small (up to 5,000 staff)
Royal Marsden NHS Foundation Trust	RPY	21	Small (up to 5,000 staff)
Blackpool Teaching Hospitals NHS Foundation Trust	RXL	21	Medium (between 5,000 and 10,000 staff)
Bridgewater Community Healthcare NHS Foundation Trust	RY2	21	Small (up to 5,000 staff)
Wrightington, Wigan and Leigh NHS Foundation Trust	RRF	21	Medium (between 5,000 and 10,000 staff)
Somerset Partnership NHS Foundation Trust	RH5	21	Small (up to 5,000 staff)
James Paget University Hospitals NHS Foundation Trust	RGP	20	Small (up to 5,000 staff)
Sheffield Health and Social Care NHS Foundation Trust	TAH	20	Small (up to 5,000 staff)
Camden and Islington NHS Foundation Trust	TAF	20	Small (up to 5,000 staff)
Northumberland, Tyne and Wear NHS Foundation Trust	RX4	20	Medium (between 5,000 and 10,000 staff)
Lancashire Care NHS Foundation Trust	RW5	20	Medium (between 5,000 and 10,000 staff)
Mid Staffordshire NHS Foundation Trust	RJD	20	Small (up to 5,000 staff)
Calderdale and Huddersfield NHS Foundation Trust	RWY	19	Medium (between 5,000 and 10,000 staff)
Leeds and York Partnership NHS Foundation Trust	RGD	19	Small (up to 5,000 staff)
Oxleas NHS Foundation Trust	RPG	19	Small (up to 5,000 staff)
Ashford and St. Peter’s Hospitals NHS Foundation Trust	RTK	19	Medium (between 5,000 and 10,000 staff)
Solent NHS Trust	R1C	18	Medium (between 5,000 and 10,000 staff)
Oxford Health NHS Foundation Trust	RNU	18	Medium (between 5,000 and 10,000 staff)
Wye Valley NHS Trust	RLQ	18	Small (up to 5,000 staff)
Newcastle Upon Tyne Hospitals NHS Foundation Trust	RTD	17	Large (more than 10,000 staff)
Birmingham Women’s NHS Foundation Trust	RLU	17	Medium (between 5,000 and 10,000 staff)
Sherwood Forest Hospitals NHS Foundation Trust	RK5	16	Small (up to 5,000 staff)
Bradford Teaching Hospitals NHS Foundation Trust	RAE	16	Medium (between 5,000 and 10,000 staff)
Central London Community Healthcare NHS Trust	RYX	16	Small (up to 5,000 staff)
Royal Brompton and Harefield NHS Foundation Trust	RT3	16	Large (more than 10,000 staff)
Hertfordshire Community NHS Trust	RY4	15	Small (up to 5,000 staff)
Luton and Dunstable University Hospital NHS Foundation Trust	RC9	15	Small (up to 5,000 staff)
North Essex Partnership University NHS Foundation Trust	RRD	15	Small (up to 5,000 staff)
Black Country Partnership NHS Foundation Trust	TAJ	15	Small (up to 5,000 staff)
Bradford District Care NHS Foundation Trust	TAD	14	Small (up to 5,000 staff)
North Cumbria University Hospitals NHS Trust	RNL	14	Small (up to 5,000 staff)
Barnsley Hospital NHS Foundation Trust	RFF	13	Small (up to 5,000 staff)
Royal National Orthopaedic Hospital NHS Trust	RAN	13	Small (up to 5,000 staff)
Cumbria Partnership NHS Foundation Trust	RNN	13	Small (up to 5,000 staff)
University Hospitals Coventry and Warwickshire NHS Trust	RKB	13	Medium (between 5,000 and 10,000 staff)
Derbyshire Healthcare NHS Foundation Trust	RXM	12	Small (up to 5,000 staff)
Sheffield Teaching Hospitals NHS Foundation Trust	RHQ	12	Large (more than 10,000 staff)
Great Ormond Street Hospital For Children NHS Foundation Trust	RP4	11	Small (up to 5,000 staff)
Manchester Mental Health and Social Care Trust	TAE	11	Small (up to 5,000 staff)
South Warwickshire NHS Foundation Trust	RJC	11	Small (up to 5,000 staff)
Isle of Wight NHS Trust	R1F	10	Small (up to 5,000 staff)
Liverpool Community Health NHS Trust	RY1	10	Large (more than 10,000 staff)
Derbyshire Community Health Services NHS Foundation Trust	RY8	9	Medium (between 5,000 and 10,000 staff)
Essex Partnership University NHS Foundation Trust	R1L	8	Medium (between 5,000 and 10,000 staff)
Manchester University NHS Foundation Trust	R0A	8	Large (more than 10,000 staff)
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust	RL1	8	Small (up to 5,000 staff)
Cornwall Partnership NHS Foundation Trust	RJ8	8	Small (up to 5,000 staff)
University Hospitals Plymouth NHS Trust	RK9	8	Medium (between 5,000 and 10,000 staff)
Lincolnshire Community Health Services NHS Trust	RY5	7	Small (up to 5,000 staff)
Northamptonshire Healthcare NHS Foundation Trust	RP1	7	Small (up to 5,000 staff)
Airedale NHS Foundation Trust	RCF	7	Small (up to 5,000 staff)
Royal Orthopaedic Hospital NHS Foundation Trust	RRJ	7	Small (up to 5,000 staff)
Devon Partnership NHS Trust	RWV	7	Small (up to 5,000 staff)
Gateshead Health NHS Foundation Trust	RR7	6	Small (up to 5,000 staff)
Dudley and Walsall Mental Health Partnership NHS Trust	RYK	6	Small (up to 5,000 staff)
George Eliot Hospital NHS Trust	RLT	6	Small (up to 5,000 staff)
Shropshire Community Health NHS Trust	R1D	6	Small (up to 5,000 staff)
2Gether NHS Foundation Trust	RTQ	6	Small (up to 5,000 staff)
Poole Hospital NHS Foundation Trust	RD3	5	Small (up to 5,000 staff)
Liverpool Women’s NHS Foundation Trust	REP	5	Small (up to 5,000 staff)
Walton Centre NHS Foundation Trust	RET	5	Small (up to 5,000 staff)
Wirral Community NHS Foundation Trust	RY7	5	Small (up to 5,000 staff)
Tavistock and Portman NHS Foundation Trust	RNK	4	Small (up to 5,000 staff)
Liverpool Heart and Chest Hospital NHS Foundation Trust	RBQ	4	Small (up to 5,000 staff)
Gloucestershire Care Services NHS Trust	R1J	4	Small (up to 5,000 staff)
Hull and East Yorkshire Hospitals NHS Trust	RWA	3	Medium (between 5,000 and 10,000 staff)
Hounslow and Richmond Community Healthcare NHS Trust	RY9	3	Small (up to 5,000 staff)
South Tyneside NHS Foundation Trust	RE9	3	Small (up to 5,000 staff)
Clatterbridge Cancer Centre NHS Foundation Trust	REN	3	Large (more than 10,000 staff)
Queen Victoria Hospital NHS Foundation Trust	RPC	2	Small (up to 5,000 staff)
Weston Area Health NHS Trust	RA3	2	Small (up to 5,000 staff)
Royal Papworth Hospital NHS Foundation Trust	RGM	1	Small (up to 5,000 staff)