5 No more trust or bust
Resolution submitted by the RCN Mid Surrey Branch
That this meeting of RCN Congress calls for government to stop closing health services for cost reasons alone
Work lead by the Public Policy Committee
Lead RCN Council member: John Hill
This Congress resolution set an ambitious agenda for the RCN. A number of significant policy levers are acting on NHS trusts in England and challenging the financial sustainability of services, including major changes to the prices paid for care under payment by results (PbR), changes to accounting rules, and significant requirements placed upon providers to increase activity levels within existing resources. Financial pressures are not unique to England. Organisations in Wales, Scotland and Northern Ireland are experiencing major reconfigurations; however financial constraints appear to have been more acute in England, so work was focused primarily on resolving problems in the NHS in England. Although the comprehensive spending review gave above average funding for the NHS for coming three years, inflationary costs and high demands on services will add to pressure to NHS providers to find ways of making savings.
Representations have been made by the RCN through the media, lobbying, conference presentations and policy briefings to create a new financial framework for the NHS. The group set up to monitor NHS deficits continues to compile evidence and information to aid local activists in resisting arbitrary or short term cuts to provision, in order to achieve financial balance. The RCN has also recently come out strongly on the reported surpluses in the NHS, calling for these surpluses to be reinvested in restoring professional development and training funds, and improving the care environment for patients and staff.
The RCN continues to argue for an NHS built on a sustainable business model which transparently and strategically reinvests surpluses in the NHS, and that this process is driven by improving quality and not just achieving financial balance. This process should begin with the Department of Health writing off historical deficits in trusts, where the extent of the deficit is likely to compromise future investment and growth in services to the public. The RCN will continue to influence the price-setting mechanism within PbR, and will work on developing commissioning capacity within nursing and the NHS in the coming year.