London rethinks plans to slash nursing numbers
The NHS is re-examining a controversial review that concluded London’s hospitals could safely slash their nursing workforce through greater productivity.
The report in February identified savings of £421m in the capital’s nursing workforce over the next three years.
But Nursing Times has learnt that senior nurses have been involved in reassessing the conclusions of the “Safe and Financially Effective” review, which was carried out by the strategic health authority NHS London using methodology developed by management consultants.
The review had concluded that London’s non-foundation trusts could safely slash their £1.5bn total nursing spend by nearly a third. Individual reports sent to trusts advised some they could reduce nursing spend by half if they matched the efficiency of similar trusts.
However, an internal document released to Nursing Times under the Freedom of Information Act shows NHS London has had to re-examine the assessment.
The document said: “The SaFE analysis was perceived to be too high level to properly comprehend the nursing productivity challenge. Further analysis of the problem is required.”
Nursing Times understands members of the senior nursing community had raised concerns about the scale of savings being suggested by the analysis and that its methodology was not sophisticated enough.
The review compared the London trusts with other similar sized NHS organisations from around the country and calculated a “productivity opportunity” figure suggesting what they could save if they were as efficient.
Nursing Times understands the second review is almost complete and the revised “productivity opportunity” is a fraction of that identified in the SaFE report at some trusts.
An NHS London spokesman said: “The first programme was a desk top review and the current pilot is a trust based data collection exercise using a remodelled template.
“It takes account of a wider group of measures than the initial desk top review, which was for indicative purposes only. The recent pilot was developed by a group of senior nurses and nurse directors from the trusts.”
Royal College of Nursing head of policy Howard Catton said NHS managers should be wary of “productivity get rich quick schemes”.
He described the original review as a “blunt assessment” that failed to take into account London’s unique workforce and population variables.
“It’s reassuring clinicians are being asked to look at what the workforce requirements are,” he added. “We’ll see what the next steps are.”
However, Mr Catton noted that nurses had been telling the college for some time that their organisations were already “lean” in terms of productivity and workforce.
Professor Anne Marie Rafferty, dean of the Florence Nightingale School of Nursing and Midwifery at King’s College London, said: “Estimates of productivity gains are as good as the definitions and assumptions on which they are based, and in this instance rely upon what a ‘peer’ trust in another part of the country might be.
“Equally such estimates need to be calibrated against demand, which seems to show no signs of slowing down.”