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District nursing would be 'decimated' by proposed London cuts


District nursing in parts of London could be “decimated” if a community trust’s plans to save millions of pounds go ahead, it has been claimed.

Hounslow and Richmond Community Healthcare Trust has put 63 district nursing posts at risk of redundancy. The trust hopes only 12 nurses will be made redundant but admits others face moving to new jobs, many of which will be on a lower pay band.

The trust said the job cuts equated to 4% of its total workforce. It needs to save £2.7m this year, equivalent to 5% of its budget.

Michael Walker, regional officer for Unison, told Nursing Times the union was talking with staff and they had not ruled out the option of industrial action.

He said: “We are not blaming the trust. They have massive cuts to inflict as a result of a decision by central government.

“This is devastating to the morale of the staff and it will leave the area’s district nursing service decimated when it is already struggling.

 “We are meant to be moving services out of hospital but this is going completely against that.”

The trust claims all efficiency saving have been reviewed for effects on quality.

A spokesman said: “We believe there is capacity within our services to work differently; it is crucial that we have the right staff, with the right skills in the right place that sits within the correct framework.

“We appreciate staff will be anxious about these proposed changes and we are doing what we can to support staff affected.”


Readers' comments (11)

  • michael stone

    I've said this before - if the idea is to treat more patients at home, and to keep them out of hospital (especially older patients), how the heck does that not imply the need for MORE DNs ?!

    Efficiency savings, even if achievable (which assumes the existence of the inefficiency) can only go so far - I get really annoyed by this mantra of 'we can achieve this through efficiency savings' BEFORE ANY TYPE OF PROOF OF THAT.

    I don't really apologise for 'shouting' - this one, really annoys me.

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  • Completely agree Mike. I've just scanned their Board papers and you'll never guess why this is happening - they want to become an FT. And the first port of call seems to be cut staff. Bonkers.

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  • According to the minister responsible for nursing issues "Call me Dan" Poulter, there is no relationship between lack of nurses and poor care (yes, the Francis report got that completely wrong too).

    Call me Dan knows best on this peeps, he was a junior doctor. All you nurses, and Mr Francis are, well, just simply wrong.

    "The NHS is safe with us"
    "No top down re-organsation of the NHS"
    "Nurses will have to get used to increased pressure"
    "The NHS should not exist"

    The next 2 years will see more of this I'm afraid and Trusts will buckle under the pressure and patients will suffer. The ministers that have/are creating these very conditions which will allow poor care will be quick to point the finger of blame.

    All the while claiming Gvt is transparent, Ministers stick fingers in their ears and sing la la la la la la, whilst the worst predictions in the suppressed Risk Register come true. They have the info at their fingertips to stop this, and subsequent, catastrophies of patient care, but if they believe that NHS should not exist what motivation do they have?

    'Private / competition is better' will be their mantra.

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  • I agree with above comments. There will never be decent community services if staff are cut, wages cut, investment cut and services trimmed. How long does it take GPs and DNs to visit and treat their patients now? It will only get worse as more people suffer at home, getting older and with more complex long-term conditions. There's not enough Nurses out there and that's one of many reasons why we're seeing rising patient numbers in hospitals.
    Stop downbanding frontline staff. Start with those at the top. How many Assistants and Assistants to Assistants do they need up there. If any Execs are needed, then they can buy their own biscuits and make their own tea / coffee and not charge it as expenses. Either pay to eat hospital food at lunch or bring/buy own food like most of us as even hospital food costs are getting expensive for us to survive on.
    If government is serious about saving money, then pay more for nursing care to prevent readmissions and conditions becoming worse or more complicated. Otherwise with less nurses, more people will die earlier. Or is this what they want, so that savings are achieved via neglecting healthcare

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  • ... more deaths = less patients = less costs of care, medication + interventions.
    Less patients = less nurses required and fewer doctors. Then leads to more unnecessary deaths...

    Saving money this way sounds very dangerous.

    Feels like government wants to turn healthcare into a business where we all pay for it. Those rich enough will get top quality treatments in their own mansions.

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  • "The nobody" is jumping to conclusions. Does anyone seriously think that trusts can opt out of cuts by withdrawing from the FT process? Of course it's wrong for there to be cuts to community services, but if we fail to understand the reasons, then it's harder to make the case against. Michael Walker in the article may have identified the root cause more accurately.

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  • There really does need to be a review of the amount of managers and their pay. So front line staff are to be downgraded then that needs to continue up the ranks as if we are on lower grades correspondingly so can they be.

    The problem for DN's is that we are measured against hospital standards such as the safety thermometer rather than evaluated on prevention of hospital admission etc.

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  • every_propeller | 20-Mar-2013 4:23 pm

    To be honest, the only reason I said that was for cynical jaded reasons having been part of an FT application process, where one of Monitor's key pre requisites is to generate an annual 4% surplus. Which is hard, given it's an effort to break even, because demand is going up but broadly funding is flat. The annual planning rules state that all trusts have to make 4% savings whether an FT or not, so most of us are looking at 8% upwards. That community organisation serves about 440K population so probably has a budget over £200M but needs to save about £20M so cuts are drastic. The article didn't give much hope to staff other than Mike's comment about industrial action, which increasingly seems like the only option left.

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  • michael stone

    By the way, getting 'philospophical'.

    I have nothing against more efficiency. I tend to approve of it.

    But more efficiency is NOT getting your staff to work harder (that isn't better efficiency), it is getting your staff to achieve more when they put the same amount of effort in.

    Working CLEVERER = more efficiently

    Working HARDER = (loosely) slave-driving your staff

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  • The Nobody | 21-Mar-2013 11:13 pm

    Fully take your point. Interestingly though the trust's budget is in fact only £55m

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