26,841 job losses put patient care in jeopardy - RCN
Published: 12 November 2010
Almost 27,000 NHS posts in the UK are already earmarked for cuts, with almost 18,000 in England alone, the Royal College of Nursing reveals today (12th November). This is more than three times the number of posts identified by the RCN in England in April, and could leave patients vulnerable and services at risk. The loss of 26,841 staff is the equivalent of closing almost six hospitals the size of the Royal Free in London, or nine hospitals the size of Alder Hey in Liverpool.
While spending on health is said to be ‘ring fenced’, nurses on the ground have told the RCN that they have been seeing major staff reductions begin in earnest, even before the comprehensive spending review confirmed the plan to save £20 billion by 2014. The RCN is concerned that fewer staff are being expected to deal with an ever increasing number of patients, often with very complex needs. The college warned that this situation could reach crisis point due to cuts in local government and social care.
Dr Peter Carter, RCN Chief Executive & General Secretary, said:
“We understand that the Government wants to protect front line services and that these are extremely difficult times. However, we have established that what the Department of Health is being told and what the public is being told is often far removed from the evidence on the ground. Right now, staff are not only concerned about losing their jobs, they are concerned about keeping services open and how they will cope if they stay. The mood at the moment suggests that it is two minutes to midnight for the NHS, and action to avert a crisis is needed now.
“Even when asked questions under the Freedom of Information Act, trusts are omitting to mention advanced plans to cut staffing numbers. The alleged protection of the health service is proving in practice to be a myth, and patients and services are not insulated from cuts.”
“The deficits crisis in 2006 saw a loss of 22,000 posts, taking skills and experience with them. The fact that we have gone from 5000 posts at risk in April to almost 27,000 in October demonstrates how fast this situation is moving, and I would urge trusts to carry out a proper impact assessment before making any changes to services. We also recommend to all managers that they prioritise safe staffing levels when they are looking for ways to save money.”
“Unsurprisingly, some of the reckless spending of the previous few years is now coming home to roost. Despite being asked to limit pay rises to the same level as staff, which was 2.75%, Ealing Hospital NHS Trust gave their Chief Executive Julie Lowe a rise in remuneration of 24% in the financial year to 2009. They are now closing a general medical ward and losing 34 nursing and support posts.”
The RCN has had contact with thousands of nursing staff through the Frontline First campaign website, and has been independently verifying the data we are given using board papers and trust documents. The RCN has also seen responses received under the Freedom of Information Act by the campaign group ‘False Economy’, which show the disparity between the official line being given out and what nurses on the ground know to be happening.
In answer to a Freedom of Information request in September 2010, the Royal Berkshire NHS Foundation Trust was asked to include all posts deleted through natural wastage as well as redundancy. They stated “No clinical posts are at risk of redundancy. There are 7 potential/planned redundancies at present. All of these posts are from Administrative and Managerial posts in Corporate Departments.” They made no mention of cuts through natural wastage. By contrast, their consultation in August 2010 states that they plan to reduce the headcount by up to 600 over the next three years.
Similarly, NHS Hartlepool, NHS Middlesbrough, NHS Redcar & Cleveland and NHS Stockton on Tees did not answer the questions put to them under the Freedom on Information Act by False Economy, but instead forwarded press statements which do not include any mention of figures the RCN has obtained.
The severity of the cuts is laid bare by the figures involved and the testimony of nurses. For example, Sandwell and West Birmingham Hospitals NHS Trust recently published plans to reduce its acute sector workforce by 899 staff. NHS Greater Glasgow and Clyde plans to cut 553 nurses and midwives as part of an overall reduction of 1252.
Dr Peter Carter added:
“Nurses and healthcare assistants are now coming to us with examples of vacancy freezes and diluted skill mix which leaves them concerned for services and patients in the here and now. The consequences are being felt – inevitably, with fewer staff, whole services are being shut down or suspended. We know all too well from examples such as Stafford hospital that if you cut back staffing levels to the bare bones, patients suffer and can be put in danger. The RCN believes that this is reckless and unnecessary and urges managers and politicians to protect patients by protecting the front line.”
“When the £20 billion in cuts was announced, we were told that this would be reinvested back into frontline services. Staff and patients will want to know if and how this is happening.”
The RCN examined board papers from hundreds of NHS Trusts, along with reports from its members and regional offices. It found the following trends:
• Almost 27,000 posts have been verified as earmarked for redundancy, vacancy freezes, natural wastage, downgrading of job roles, or ceasing the use of agency and temporary staff. For example, North Tees and Hartlepool NHS Foundation Trust is undertaking a cost cutting exercise, equivalent to 5% of its total budget. The trust is planning to reduce 359 whole time equivalent posts.
• Several Trusts are reviewing skill mix so that non-registered staff provide more care. For example, East Lancashire Hospitals NHS Trust is making changes to its skill mix by proposing to fill Band 6 (the pay grade of an experienced nurse) and band 3 (a skilled healthcare assistant) posts with band 5 (a newly qualified nurse) and band 2 (a less skilled healthcare assistant) should vacancies arise.
• Trusts are actively re-banding or down-banding posts in order to secure savings. For example, Derby Hospitals NHS Foundation Trust is reviewing their banding system for Clinical Nurse Specialists and Outpatients in some directorates. Staff have been warned that they are at risk of downbanding away from specialist roles.
Few Trusts are taking innovative approaches to finding efficiencies by consulting with expert clinical staff. Some are wasting significant sums on items which are unrelated to patient care. For example, The NHS in Buckinghamshire has spent £62,222.44 on installing wet rooms and height-adjustable baths to a specialist centre for neuro-patients, shortly before the centre ceased being residential and stopped being used for rehabilitation. The bathrooms were installed in March and are no longer being used.
The RCN has also heard from our members about innovative ideas they have put in to practice which can and do save the NHS money. For example:
• Senior nurse Ray Gerrard from Liverpool saves the NHS almost three thousand pounds per year just by improving the system for purchasing items such as crutches, gloves, gauze swabs and dressings.
• Nurse Donna Keenan from Omagh in Northern Ireland has set up a unit to assess and treat patients with life-threatening heart conditions. The unit is staffed by cardiology nurses, and manage 84% of patients who would otherwise have to travel 30 miles to A & E.
Dr Peter Carter added:
“It would be a tragedy if the health service were to take a step backwards because the voice of clinical staff with positive ideas was not heard. We will speak up for our members, who are telling us about their escalating concerns about cuts and waste. On a more positive note, we have seen instances recently where the RCN has met with senior managers locally and received guarantees that redundancies and vacancy freezes will not take place, such as at the St Luke’s Hospice in Sheffield. I would urge all trusts to engage with staff to avoid the serious consequences of squeezing the NHS further.”
The Frontline First campaign site can be found at www.rcn.org.uk/frontlinefirst
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Notes for Editors
1. The posts identified include nurses, midwives, health care assistants, clinical support staff, doctors, medical consultants, allied health professionals, administrative, clerical, estate and housekeeping staff.
2. The total does not include the potential job losses resulting from reduction in management costs by 45%, and abolishing Strategic Health Authorities (SHAs) and Primary Care Trusts by 2013.
3. The RCN has seen data collected by campaign group ‘False Economy’, who have carried out Freedom of Information requests on hospital trusts. For more information on this group, please visit their website at http://falseeconomy.org.uk/
4. For further information, interviews or illustrations please contact the RCN Media Office on 0207 647 3633, press.office@rcn.org.uk or visit http://www.rcn.org.uk/newsevents/media
5. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations.