Sustainability and Transformation Plans (STPs) are being developed to change health and social care services across England and have forecast a total shortfall of £22bn by 2020/21.
There are 5 STPs in London, with a total funding gap of over £4bn. However in the Autumn Statement on 23 November the Chancellor failed to set out any new funding to support the scale of the changes.
Without extra funding from the Government the gap will have to be made up by reducing or centralising services.
STPs are proposing significant changes to the shape, composition and size of the healthcare workforce, with some including an increased use of non-registered nursing roles in order to increase savings.
Many recent studies have highlighted the important link between the proportion of registered nurses and improved patient mortality.
The RCN says that the timescale for STPs, which will see plans agreed and up and running by April 2017, has meant that plans have been drawn up without meaningful engagement and proper consultation with staff, patients and the local communities that use services.
RCN London Regional Director Bernell Bussue said: “The scale of change described in the STP plans will be extremely hard to deliver with the current funding levels provided to the NHS. The Government should recognise the extra investment needed by local health leaders and provide the funding needed to guarantee a truly 21st century health service.
“Staff, patients and trade unions must be given the opportunity to engage in the STP process. It beggars belief that such far-reaching and potentially de-stabilising changes to the NHS could take effect before there has been any meaningful dialogue with the public, patients or staff.
“The importance of having enough skilled nurses in the NHS cannot be overstated. Yet education budgets for continued professional development have been drastically reduced, compromising the capacity to train and prepare nursing staff for new ways of working.
“The Government has to do much more to reassure staff and patients that STPs are not simply for driving forward cuts to services and costs. Patients will be at risk if registered nursing posts are cut just to save money.”