NHS trusts are determined to protect patient safety as a new
survey by NHS Providers reveals services are being scaled back
and jobs cut as the demands of the NHS financial ‘reset' become
clear.
With the NHS looking to recover a predicted financial shortfall
that reached nearly £7bn this year, trusts have been asked to
drastically reduce running costs while improving performance
against key targets.
With the 10-year health plan due to be published in the coming
months, nearly half of trust leaders (47%) surveyed warned they
are scaling back services to deliver tough financial plans, with
a further 43% considering this option. Virtual wards,
rehabilitation centres, talking therapies and diabetes services
for young people are amongst services identified at risk,
demonstrating the extremely tough choices being faced by NHS
leaders.
Worryingly, over a third (37%) said their organisation is cutting
clinical posts as they try to balance their books, with a further
40% considering this. With trusts told to halve corporate cost
growth, 86% of trust leaders said their organisation is going to
have to cut posts in non-clinical teams - such as HR, finance,
estates, digital and communications – potentially risking efforts
to deliver services, innovate, and improve productivity.
The scale of job cuts is becoming clear with a number of trusts
aiming to take out 500 posts or more and one organisation
planning to cut around 1000 jobs.
With further reductions to temporary staffing costs (91%) and a
recruitment freeze (85%) also on the cards, the impact of these
changes on hardworking and overstretched front-line teams is a
major concern for trust leaders. More than nine in ten
(94%) said the steps needed to deliver financial plans would have
a negative impact on staff wellbeing and culture at a time when
morale, burnout and vacancies are taking their toll and disquiet
over pay and conditions is rising.
Now trust leaders have called on the government to recognise the
difficult decisions and competing priorities trusts face as they
try to improve patient services while trying to balance the
books.
The survey by NHS Providers, which represents hospital, mental
health, community, and ambulance services also found:
- More than one in four (26%) said they will need to close some
services (a further 55% are considering this).
- 45% are moderately or extremely concerned their actions will
compromise patient experience
- Close to three in five respondents said patient experience
(61%), work to address health inequalities (60%) and access to
timely care (57%) were most at risk of being impacted.
- Nearly nine in ten (88%) said they don't have enough funding
to invest in prevention
The interim chief executive of NHS Providers Saffron Cordery
said:
"Trust leaders will always put patient safety and quality of care
first.
“They're acutely aware of pressures on the public purse, the
scale of the challenge they're facing and their duty to make the
most of every pound that goes into the NHS. They're working hard
every day to find efficiencies, cut costs and make savings
without compromising safety. They're at the forefront of efforts
to shift care from hospitals to the community, from analogue to
digital and from treating sickness to preventing ill-health.
“Trust leaders have also heard loud and clear that overspending
will not be tolerated and have made major inroads in tackling the
huge financial deficit facing the NHS.
“But let's also be clear: cuts have consequences. NHS trusts face
competing priorities of improving services for patients and
boosting performance while trying to balance the books with
ever-tighter budgets. National leaders must appreciate that makes
a hard job even harder.
“It's really worrying to hear trust leaders tell us highly valued
staff and services including vital work to address health
inequalities and prevention could be among the early casualties
of budget cuts. These decisions are never taken lightly and will
always be a last resort.
“They're committed to working with the government to build
a better health service but fear immediate financial pressures
could undermine plans to transform the NHS.”
Ends
Notes to editors
- The survey ran from 15 April - 27
April and NHS chief executives, chairs and other board executive
directors were invited to respond. We received 160 responses to
the survey from 114 unique trusts. This accounts for 56% of the
sector (205 trusts in England). Responses covered all regions and
trust types in England including acute, acute specialist,
ambulance, community and mental health trusts.
- We have written to the Secretary of
State for Health and Social Care to set out the survey findings.
- NHS Providers is the membership
organisation for NHS hospital, mental health, community and
ambulance services that treat patients and service users in the
NHS. We help those NHS foundation trusts and trusts to deliver
high-quality, patient-focused care by enabling them to learn from
each other, acting as their public voice and helping shape the
system in which they operate.
- NHS trusts in England collectively account for £132bn of
annual expenditure and employ 1.4 million people.
