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The unidirectional nature of the cross-over (from control to intervention) within the stepped wedge may mean that factors external to the trial (eg, the start of other interventions such as universal prescription of vitamin D, systematic changes to staffing profile, activities or patient casemix) have the potential to contaminate the trial results if they arise.
This is suggested not only by the ongoing layoffs, but by reported changes to staffing procedures.
Any changes to staffing size or structure are simply a reflection of standard business optimization.
As for what such a move while mean for the company's team moving forward, Pini says that he does not anticipate any major changes to staffing, though some smaller scale ones may occur throughout the transition.
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In recent months several big high street names have made changes to staff conditions to offset some of the increase.
Govia Thameslink Railway (GTR), which operates Southern trains, said it would press ahead with planned changes to staff roles, which were due to start being implemented next week.
Murdoch MacLennan, the chief executive of parent Telegraph Media Group, unveiled a number of changes to staff including the first initiatives arising from an operational review by Deloitte.
Chris Bown, chief executive at Poole Hospital NHS Foundation Trust and chair of the SWC, said that by making changes to "staff pay, terms and conditions", up to 6,000 NHS jobs could be safeguarded.
WLGA chief executive Steve Thomas said opposition to changes to staff terms and conditions was a real problem.
It includes 750 voluntary redundancies and changes to staff terms and conditions but could also see hundreds of compulsory redundancies.
It said changes to staff terms were driven by a need for a "fair, consistent and transparent" pay and allowances system.
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