Doctors’ leaders have launched an attack on England’s most senior nurse over comments she made recently about NHS regional plans, which they claim support moves that “will harm patient care”.
In an unprecedented step, the British Medical Council’s governing body is due to debate a vote of no confidence in chief nursing officer Professor Jane Cummings later today.
“I think her position is now untenable”
Those behind the unusual move say it was prompted by an article published in a national newspaper just after Christmas, in which Professor Cummings discussed the 44 sustainability and transformation plans (STPs) being developed jointly by trusts and councils across England.
The piece, originally published in the Telegraph and subsequently as a blog by NHS England, provoked an angry response from those who see STPs as a mechanism for crippling budget cuts and the closure of services, as part of NHS England’s efforts to save £22bn by 2020.
In the article, Professor Cummings talked about the need to change “outdated models of care so that patients don’t fall into the cracks” and the need to ensure that ”we provide care based around their needs, and not those of NHS organisations”.
Among several examples, she highlighted the situation in Devon, where “the local NHS wants to invest in home-based care, but it struggles because resources are currently tied up in hospital beds”.
“With more care provided at home, the NHS can spend more case on patients rather than maintaining old and expensive buildings,” said the CNO.
She acknowledged that “whatever the merits” of the STPs, the choices included in them would “always be controversial because we are talking about changes to strongly supported services that have served communities well for years”.
“While there will always be a vigorous debate about how much money the nation invests in the NHS and in social care services, that does not change our responsibility to patients, which is to squeeze the maximum value and the best possible care from every penny that is made available to us,” she said.
“I am sad about this rather odd attack by a consultant on a nurse”
But Dr Clive Peedell, a consultant oncologist and member of the BMA Council, interpreted the comments to mean Professor Cummings favoured investing in community care at the expense of hospital beds.
Dr Peedell, who is also co-founder and former leader of the National Health Action Party, said he was so incensed by the piece that he “no option” other than to propose a vote of no confidence.
Writing on his page on social media site Facebook, he accused the CNO of being “completely out of touch with expert opinion” and the “consequences of another £22bn of NHS ‘efficiency savings’”. “I think her position is now untenable,” he said.
Speaking to Nursing Times, Dr Peedell confirmed today’s debate would go ahead as he had secured support from the appropriate number of council members to get an item added to the BMA Council’s agenda. Items must be supported by a minimum of 10 council members to be debated.
“I secured the appropriate number of council members to put it on as an agenda item, therefore, it will be debated,” he said. “Whether the BMA does pass a vote of no confidence will depend on the vote of council.
“If we vote in favour of a no confidence vote that will be the opinion of the BMA – it will be BMA policy – so it is a big issue,” said Dr Peedell.
Doctors’ leaders to hold vote of no confidence on CNO
However, he acknowledged it would be a “hard motion to pass”, and admitted some colleagues had reservations about the idea of doctors publicly criticising a nursing leader.
He suggested Professor Cummings had “been caught in a really unfortunate position” and was being used as a political pawn by writing an article that seemed to whole-heartedly support STPs.
“It is a classic political tactic is to get trusted people – and public do trust doctors and nurses – to do their dirty work for them and it has caused huge damage over the years,” he said.
“She is obviously a brilliant leader – she wouldn’t be in her position if she wasn’t – but with that comes responsibility and she has got it totally wrong,” said Dr Peedell.
In addition, he claimed to have backing for his motion from nurses. “I have had a lot of support from nurses already – a number of nurses have got in contact with me saying ‘let’s hope the RCN follow suit’,” he said. “And I do hope the RCN will take notice and put their own motion of no confidence.”
However, this seems unlikely as the RCN has so far come out strongly in support of Professor Cummings. In a series of posts on social media site Twitter, deputy director of communications and campaigns Jane Hughes said a vote of no confidence would not help the NHS or patients.
“[It’s] not helpful to make this personal,” she wrote. “Better to push for proper consultation on STPs in interests of patient care.”
Meanwhile, NHS England has also leapt to the defence of the CNO, claiming Dr Peedell had misunderstood her comments.
“To be honest, this is a bizarre motion that is factually inaccurate and suggests that he hasn’t even read the original article,” said Hilary Garratt, NHS England’s director of nursing and deputy CNO.
“The published piece makes no reference whatsoever to cutting acute beds,” she said. “If Clive Peedell wishes to engage in a debate he needs to do so on a factual basis.”
She added: “I am sad about this rather odd attack by a consultant on a nurse. Clive has been systematically misrepresenting what was actually said.”