Is the NHS, as an employer, overburdened with regulations relating to its obligations to employees?

Purpose - The purpose of this paper is to provide an introduction to the existing regulations relating to the obligations of the NHS to its employees and to discuss whether the NHS is overburdened with these regulations.Design methodology approach - Provides an overview of the current employment regulations and their impact on the NHS. The authors conducted a literature search in August 2009 on EMBASE, HMIC, MEDLINE, PsycINFO, HEALTH BUSINESS ELITE (1995-2009) using the terms "NHS employee", "NHS employer", "Employment laws". The reference sections of retrieved papers were hand-searched for further relevant references.Findings - The NHS seems to differ from other employers in several aspects. It has always remained high in political agenda, and has had to face high public expectations. The NHS has a huge workforce from a variety of disciplines regulated by different external agencies. There are several areas where it seems that the NHS is struggling with the obligations to its employees. The law regarding the employment contract, redundancy and termination of contract puts the NHS management, as revealed in many case laws, in several legal dilemmas. The working time directives, time off work provisions and the rapidly changing health and safety obligations do not give flexibility and thus create practical problems to the human resources department. The ever-growing financial obligations seem to be challenging even the very existence of the NHS.Originality value - The value of this paper is in drawing attention to the fact that existing employment law is complex and consists of several complicated statutes. The NHS is also going through a period of rapid changes, in trying to set and meet stringent and unrealistic national targets and thereby putting enormous pressure on its management and workforce. The NHS is therefore struggling in several areas with the obligations to its employees.