WITH cuts hitting hard, healthcare in East London is undergoing huge changes.

Last week, NHS Tower Hamlets announced its management team is merging with Hackney and Newham and the three must halve their budget by April.

A new way of delivering healthcare – with GPs in charge of running services – is being phased in before the Primary Care Trusts are abolished in April 2013.

At the helm of all these changes is Alwen Williams, the newly appointed chief executive for the three boroughs.

The Advertiser met up with her to discuss job losses, whether the new roles GPs have will affect services and how she is planning to wipe �14million off the management budget while protecting frontline services.

Q: How many jobs to go by January?

A: “There will be an estimated 180 job losses over three PCTs in finance, estates, human resources, communications, IT, and admin support roles. Frontline nursing and clinical posts will not be affected.”

Q: Does this mean the departments were overinflated?

A: “In recent years, the roles of the PCTs have been very important but when you’re in a difficult financial position, difficult choices must be made. That’s not to say we were overinflated because all of those posts were directed at improving healthcare.”

Q: What will the new posts be?

A: “They will be in the GP commissioning consortia. There will be strengths in having clinicians leading services because they see patients on a day to day basis and understand the needs their needs. But we need to ensure will need advice from finance people, commissioning staff and others.”

Q: Don’t GPs have enough on their plates?

A: “In East London, there’s a real enthusiasm among GPs to take on these new responsibilities. It won’t be every GP, it will be a number of GPs who take a particular clinical leadership roles. That allows the majority to continue in their surgeries.”

Q: Will there be as many GPs working in surgeries as there are now?

A: “It’s taking some of those GP leaders who are already in key leadership roles forward. In many ways it feels like a natural next step. It can be attractive for GPs as they can continue to practice but also influence the shape of healthcare delivery.”

Q: Are GPs happy about it?

A: “It’s been positive on the whole. That’s not to say there aren’t some anxieties. Were offering commissioning support services over the next two years.”

Q: How can you deliver with less cash and less staff?

A: “We will aim to drive out inefficiency and make the resources we have left go further. It will be a challenge but one I’m confident we have the commitment of staff to see it through.”

Q: Will people see a difference in their services?

A: “My hope is they might see an improvement. If you look at our track record, many services are now provided closer to where people live, quality is improving and there are more specialised services. For example, the new heart attack centre at the London Chest Hospital has reduced mortalities from heart attack by about 50 per cent.”

Q: How will you ensure each borough’s individual needs are met?

A: “There are likely to be three GP consortiums. It’s more effective to have one expert contracting team, for example, than three. But the management team is certainly not going to impose a one size fits all.”

Q: Are you confident aims will be achieved in the budget?

A: “I’m very confident in the staff. I think they will rise to the challenge.”

Q: Can you assure us frontline jobs are safe?

A: “I think we are doing everything we can to absolutely protect the frontline delivery of healthcare services.”