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Nursing ripe for efficiency drive, says report

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Nursing across the board is ripe for a major efficiency drive, according to a major report on potential NHS productivity savings commissioned by the government.

The report, written by management consultants McKinsey and seen by Nursing Times, looked in detail at ways health service managers could make cuts in line with the government’s target of saving £20bn by 2013-14.

As has been widely reported, the report recommended that 10 per cent of the current NHS workforce, equivalent to 137,000 posts, should be axed – an idea that ministers said they had rejected.

Health minister Mike O’Brien said: “The government does not believe the right answer to improving the NHS now or in the future is to cut the NHS workforce.”

However, as Nursing Times revealed last week, foundation trusts are already looking at reducing their nursing staff due to pressures from the recession, which when applied to the rest of the NHS could mean at least 6,500 acute and mental health nursing jobs disappearing.

The McKinsey analysis looks at a range of potential efficiency savings, from improving staff productivity to cutting services that might allow the NHS to trim its workforce and its spending.

It advised ministers that £3bn alone could be saved by increasing staff productivity in NHS hospitals, while a further £1.9bn could be saved in productivity among non-acute staff.

The management consultants argue that nurses in the worst 10 per cent of acute trusts deal with less than a fifth of the volume of patients that those in the best 10 per cent handle.  

The report also claims that the NHS could provide the same level of district nursing services as at present with 15 per cent fewer nurses – if productivity could be increased (see story, right). 

The consultants looked at the overall time nurses in hospital settings spent on patient care and other duties, with implications for the ratio between qualified and unqualified staff.

The interpretation appears to be that more HCAs should be employed to carry out this work, while fewer registered nurses are needed for the more technical side of care.

It also recommended “reviewing” plans to increase staff included in the national stroke strategy and the children’s service strategy. 

Additionally McKinsey singled out several clinical areas to make savings in, including cutting unnecessary diagnostic tests, follow-up outpatients appointments and procedures with “limited clinical benefit” such as varicose vein removal.

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