Even in these worrying times when big savings must be made, we will still be working with much better funding than in the past, says Lynn Young, your RCN Adviser. However, the real trick now will be to prevent alcohol abuse, prevent obesity – in other words, to prevent preventable disease – so we can afford to give high quality care to those with unexpected illness or injury.

Credit crunch, economic decline, rising levels of unemployment, increasing work demands and the demand to reduce NHS funding – read all about it in the current media! It is all very discouraging, and times are extremely tough for many as a great number of family breadwinners are losing their incomes. Meanwhile others continue to work, but the threat of unemployment is ever present. It seems incredible that the nation can shift so rapidly from economic growth and strength to near bankruptcy.

The state of the NHS cannot be separated from the economic health of the nation and we now know that savings of £20 billion have to be found over the next few years. As challenging as this may sound, we also need to recall that it was not so many years ago in the early years of the Blair regime that funds allocated to the NHS were almost trebled.

So, even after £20 billion has been taken out of the kitty, funding will still far exceed previous times. However, we have all grown accustomed to abundance and it may prove tricky to carry out our work to high standards in leaner times.

On top of this, all four countries in the UK have plans in place to improve and expand community health services within the newly restricted budgets. With an election looming - spring 2010 looks the likely time - there simply will not be the appetite to diminish hospital beds, let alone close a hospital.

A new era for the NHS

The call is out to work smarter, become more efficient and do more, while at the same time improving the quality of care with less funding. So while this sounds like an impossible ambition, we are all able to point out the massive waste of NHS funding which we see most days while we are at work.

The latest document from the English Department of Health, NHS 2010 – 2015: from good to great, was published at the beginning of December and talks about the NHS entering a new era. The new NHS is, apparently, all set to be people centred, of high quality and prevention focused.

It is the prevention side of health care which interests me most for there are some startling predictions which are shameful to comprehend. Unless there is some drastic and effective action taken on alcohol abuse we are going to see a tenfold increase in the number of young people needing liver treatment in the next few years. If we fail to prevent obesity, the NHS could become bankrupt as a result of diabetes ... and so it goes on.

If we have any hope at all in maintaining an affordable NHS in the UK, we have to do everything possible to ensure that preventable disease is prevented, with the result that we are then well placed to provide high quality care to those people suffering from unexpected trauma and disease.