London hospitals have been advised by management consultants they could save £421m over the next three years through a major shake-up of nurse productivity, Nursing Times has learnt.
A report commissioned by strategic health authority NHS London identifies ways 18 hospital trusts in the capital could make savings worth £1.27bn, with nearly a third of the total coming from changes to nursing.
The report, written by consultants McKinsey and released after the Freedom of Information Act, claimed increasing nurse numbers was no guarantee of raising care quality and instead advocates increased efficiency and productivity.
It said: “There is no clear evidence that investment in simply increasing the number of nurses as the mechanism to increase the quality of nursing care is a guarantee of good patient care – many of the best health organisations in the world combine high productivity and excellent quality.
“This suggests that other factors, such as ways of working, may be more important than resourcing levels.”
The report said savings could come from “optimising skill mix, reducing agency use, increasing share of patient-facing time and aligning staffing levels with clinical need”.
The consultants based their findings on a comparison of the 18 non-foundation trusts against similar organisations elsewhere in the country.
It added that some clinical specialisms will “undoubtedly” need more staff and resources, but said “efficiency improvements will enable others to deliver improved quality with fewer staff”.
The report’s findings appear to fly in the face of analysis by Nursing Times showing the more registered nurses that a trust employed per bed the fewer of its patients were likely to die or experience long hospital stays.
A major US study, published last year by the New England Journal of Medicine, also found mortality rates were significantly affected by the number of nurses on a ward.