Public health nursing jobs are at risk in Shropshire, a union has warned, following the local council’s decision to reduce funding for services by around 14%.
Unite has claimed that 19.5 whole-time equivalent specialist community nurse posts, mainly including senior health visitors, are set to be removed under Shropshire Council’s new service for 0-25 year-olds.
“The rhetoric is to improve services, but the actual agenda is to drive through cuts estimated to be £600,000 a year”
Health visitors are set to be replaced with less well-qualified staff “who may not be trained to pick up these serious problems,” claimed the union.
Since 2015, local authorities in England have taken over the responsibility for commissioning public health nursing services.
Shropshire Community Health NHS Trust, which provides the current service, has been commissioned by the local authority to also provide the new service, from October.
The council has cut the trust’s annual budget for the service by around £640,000 a year, but has claimed that, because it is integrating its school nursing and health visiting services under a new model, it is ”difficult to draw a comparison between the current and future budget”.
“I would go further and question why our nurse leaders, nationally and at local level, are not standing up for specialist nurses”
Currently the council provides £3.7m for health visiting each year and £762,500 for school nursing per annum, which in total is around £4.47m. Under the new model for 0-25 year-olds, it is funding services with £3.83m per year.
Unite, which includes the the Community Practitioners’ and Health Visitors’ Association, is calling on the local council to reverse what it is describing as the “tsunami” of cuts.
It also said directors of nursing must do more to protect staff, instead of removing specialist nurse posts “with reckless abandon”.
“This is the thin end of the wedge and we are calling on the Shropshire public to make its collective voice heard before the consultation process ends on 8 September, so these proposed cuts are stopped in their tracks,” said Unite regional officer Stuart Baker.
“The rhetoric is to improve services, but the actual agenda is to drive through cuts estimated to be £600,000 a year – or a 14.3% budget cut for these services,” said Mr Baker.
“Without the support for breastfeeding; supporting maternal mental health, early intervention for developmental problems, and early work to intervene and prevent families entering the child protection arena, we are creating a cruel society which perpetuates health inequalities among the most vulnerable,” he said.
“It makes a savage mockery of the Tory government’s investment in the implementation plan to increase the health visitor workforce,” he added, referring to the former policy introduced by the coalition.
Unite lead professional officer Jane Beach highlighted recent calls by the head of the Nursing and Midwifery Council to address staffing issues. This followed an NMC report, published last month, that showed its register of nurses had shrunk for the first time in recent history.
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“I would go further and question why our nurse leaders, nationally and at local level, are not standing up for specialist nurses,” said Ms Beach.
“Instead, what is happening is directors of nursing in trusts in England are implementing new models of community public health nursing services that are removing specialist nurse posts with reckless abandon,” she added.
In a joint statement, Shropshire Council and Shropshire Community Health said the new integrated health visitor and school nursing service would provide a much better offer for children and families than at present.
“This is a new, and evidence-based, model of care that will involve some innovative changes”
They said the new service had a “clear focus” on prevention, early identification of needs and early intervention.
“The aim is also to ensure that the most appropriate person supports the child or young person and their family,” they stated, adding that they also recognised the importance and need to retain staff.
The trust’s director of nursing said that, while the organisation did not expect there to be any job losses, “some of our staff will be asked to work differently and we will support them through this process”.
“This is a new, and evidence-based, model of care that will involve some innovative changes to the way our health visiting and school nursing services work together to provide quality, safe care to children and young people,” he said.
“At this stage, we are working with our staff to develop this new model of care,” added Steve Gregory, director of nursing and operations at Shropshire Community Health.
“Our new contract for the 0-25 services includes efficiency saving to reflect these national cuts”
Councillor Lee Chapman, cabinet member for health at Shropshire Council, highlighted that the local authority faced ongoing cuts to the public health grant it received from the government.
”We continually face ongoing cuts in the public health budget, with a 2.3% reduction in our budget each year,” he said. “On top of that Shropshire receives one of the lowest public health grants on a per capita basis in the country this equates to £40 per head in Shropshire, compared a national average of £60 and in some areas in London, £141 per head.
“This obviously has an impact on the services the council provides, and our new contract for the 0-25 services includes efficiency saving to reflect these national cuts,” he added, but stressed that the new service would improve the county’s services.