The RCN has said the NHS has identified 10,000 frontline jobs that will go in order to make financial savings.
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The RCN trawled trust board papers to find 9,973 jobs that have been earmarked for redundancy, vacancy freezes, natural wastage, downgrading of job roles, or ending the use of temporary and agency staff.
RCN general secretary Peter Carter said nurses understood that the NHS needed to make up to £20bn of efficiency savings by 2014, but he said the RCN data “exposed the myth” that frontline services will be protected as the NHS struggles to meet its financial challenges.
“We believe the government when they say they want to protect NHS care,” he said.
“However, local NHS organisations appear to be adopting a slash and burn approach to jobs, which is shocking, and will have a disastrous effect not only on the quality of care provided but also on the range of treatments that are provided”.
The RCN found some trusts are reviewing their skill-mix so that non-registered staff will provide more care, and others are re-banding or down-banding nursing posts to achieve savings. It said there was a “trend” of trusts pledging not to cut frontline jobs as long as staff were flexible and willing to accept changes to working conditions.
Mr Carter said few trusts were consulting with staff on where jobs should go, or trying to make savings through clinical evidence-based reconfiguration of services.
“Frontline staff know where the efficiencies can be made and trusts should therefore engage with staff to ensure better care,” he said.
NHS Confederation acting chief executive Nigel Edwards said some trusts may decide not to fill posts or to reduce staff numbers to meet “constrained budgets”.
He called on trusts to be clear and open about how they will produce savings and manage staff numbers.
“All NHS organisations will be looking at how they can best manage their finances to continue delivering high quality patient care; the best ones will be ensuring this is done transparently and in consultation with staff,” he said.
The Patients Association said the Department of Health must ensure local NHS bodies do not jeopardise the availability of safe and high quality care for financial reasons.
Patients Association director Katherine Murphy said: “Whether they are hiding behind not replacing retiring nurses or freezing recruitment, the end result is the same-less staff to care for patients.”
The RCN has launched a Frontline First campaign calling on nurses to submit examples of where cuts are being made, or innovation introduced, in NHS frontline services.