Patients being let down by raid on specialist services, warns RCN
Published: 04 May 2011
Embargoed until 00:01 Wednesday 13 April 2011
Patients being let down by raid on specialist services, warns RCN
Patients risk being forced into hospital due to short-sighted cuts to specialist services, the Royal College of Nursing (RCN) warned today. An RCN survey has identified that trusts are slashing crucial specialist nursing care for sufferers of conditions such as cancer, diabetes and multiple sclerosis. The RCN is calling for Trusts to heed “compelling evidence” of savings as high as £23 for every pound spent, and invest in nurse-led schemes that keep people out of hospital, save money and improve patient care.
An RCN survey of almost 800 specialist nurses revealed that nearly two thirds (62 per cent) are seeing cutbacks in their specialist area and more than a third (38 per cent) are being asked to work outside their specialist area to cover staff shortages, jeopardising their time with vulnerable patients. Almost 80 per cent of respondents reported that financial pressures within their Trust are having a negative impact on patient care and more than one in ten (11 per cent) stated that they are now at risk of redundancy.
Specialist nurses are able to spend dedicated one to one time with patients with serious conditions, helping them in a variety of settings with issues from drug treatments to exercise plans and helping to ensure that patients have the highest possible quality of life. More than half of cancer specialists (53 per cent) are aware of cuts with nearly one in ten (9 per cent) currently at risk of redundancy.
The RCN today called for an alternative to these short-term measures and for investment in innovative nurse-led schemes. Analysis by independent experts Office for Public Management (OPM) revealed that one scheme in Cheshire generated cost benefits of up to £23 for every £1 spent on specialist nursing services, along with significant improvements in patient care.
Dr Peter Carter, Chief Executive & General Secretary of the RCN said:
“It is astounding that in the face of such compelling evidence, the NHS is once more engaging in a misguided raid on the budgets for specialist services, which save massive amounts of money in the long run. This will seriously damage both the NHS budget and patient care.
“Imagine for instance that you are diagnosed with cancer – a life changing experience with massive emotional and physical implications. With a specialist nurse, you will have one expert, your nurse, who can guide you from dealing with the diagnosis, helping your family, avoiding the complications of treatment, and keeping you out of hospital. That person is your front line. Without this consistent help and support, we fear that many people will be sent back to hospital unnecessarily; this is not just a cause of unnecessary distress, it is a false economy, and the consequences will be felt by patients throughout the NHS.”
The OPM analysis also shows that an oxygen therapy service in Central & Eastern Cheshire Primary Care Trust saves up to £1.1m per annum and improves the quality of life for patients. Over a nine month period, 299 patients were kept at home, who would have been admitted to hospital, thanks to increased community support. The number of patients prescribed oxygen was also reduced by an average of 20 per cent. Benefits for patients include more time at home, improved patient self-care and independence and a reduced likelihood of infections acquired in hospital.
OPM data suggests that for every £1 spent, the service generates between £20.22 and £23.51 of benefits, not including additional benefits such as improvements to patient quality of life. If each of the 152 NHS Trusts in the UK prevented just two emergency COPD admissions per month, the overall cost saving would be £8.5m per annum.
Similarly a pilot project by Bradford & Airedale Community Health Service achieved a 32 per cent reduction in pressure ulcers, while also reducing costs by £90,000 a year. If the number of admissions to the NHS of care home residents with pressure ulcers was halved, the NHS would save £1bn per year.
RCN Chief Executive & General Secretary Dr Peter Carter said:
“Innovative nurse-led schemes, which not only improve patient care but also save money are the future of the NHS. They provide high quality care and many of them could easily be rolled out across the health service, saving millions of pounds. In many instances, care can be best managed by community-based services, with as little hospital involvement as possible.
“The demand for their services is growing all the time – a recent survey showed that referrals have gone from 250,000 in 2006 to 1.2 million in 2010 . Given that more and more people are living for many years with conditions such as cancer, the NHS should be prioritising the care which patients find so valuable, especially as it saves so much money.”
A parallel consultation of leading health organisations (such as Macmillan Cancer Support, Epilepsy Action and Parkinson’s UK), showed that more than 62 per cent had seen cutbacks in specialist nurse services in their field. Many specialist nurses have been targeted for cutbacks during previous downturns, and the RCN is concerned that their unique skills may be lost from the NHS forever.
Both the nurses themselves and other organisations have identified that many specialist nurses are being compelled to work as general nurses back on the ward in order to cover shortages and are being taken away from their specialist work.
One nurse told the RCN:
““By working on the wards one day per week, as a team of specialist nurses we have in effect lost 21.5hrs of specialist nursing time over one week. We are covering band 5 shifts, and paid at band 7 . not the most obvious cost saving!”
Ciarán Devane, Chief Executive of Macmillan Cancer Support, added:
“We know that the NHS is under a lot of pressure to cut costs, but NHS managers need to make good choices on how they respond to this. Instead of asking some specialist nurses to do routine work, they should ensure specialist nurses are using their skills to make patients happier and healthier so they spend less time in hospital - therefore saving the NHS money.
“If the NHS is to meet the quality and productivity challenge, one thing it can’t afford to do is cut specialist support. It is proven that Clinical Nurse Specialists improve patient care and save the NHS money in the long term by keeping patients out of hospitals, where they often don’t need to be if they are given the right care and support.”
Ends
Notes to editors
1.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
2. 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