Thousands of nursing posts are set to be axed by NHS foundation trusts over the next three years despite fears over short-staffed wards and quality of care.
Overall, there will be brutal reductions of around 30,000 WTE staff during the 2014-16 period, primarily in nursing, according to the review.
The latest figures on nurse reductions have emerged in the annual review of foundation trust plans by regulatory body Monitor, which were published today (see box below).
The review shows that FTs reduced their whole time equivalent (WTE) nurse numbers by 4% during the last financial year 2012-13, which ended in March.
During the current financial year they plan to recruit an extra 4,133 nurses, a 2% increase. But the rise is seen largely as a “short-term fix” and will be followed by a further 4% cut in nurses across 2014-15 and 2015-16.
This is despite predictions by the Centre for Workforce Intelligence of a potential nursing shortage. It believes the NHS is likely to have 47,500 fewer nurses than it needs by 2016, as revealed by Nursing Times.
Monitor said the 145 foundation trusts in the NHS planned to spend £500m in 2013-14 to increase clinical staff.
They are seeking to recruit 4,133 nurses, 1,134 permanent consultants and 1,273 junior doctors this year with the remaining 3,400 made up of healthcare assistants, paramedics, social care and theatre staff.
Trusts will also off-set the cost of this recruitment by imposing a 39% cut in the use of bank and agency staff this year.
But Monitor said the plans suggested the investment was a “short term fix” to deal with “operational pressures” and the fallout from the Francis report and last week’s Keogh review, which drew links between staff shortages and higher than expected mortality rates at 14 trusts.
In the following years, cuts to nursing posts will form part of each organisation’s attempts to make savings through cost improvement programmes.
Monitor has warned traditional sources of savings are “nearing exhaustion”, with “limited evidence of transformational schemes” needed to reduce demand on acute services.
It will be an increasingly uphill struggle for foundation trusts to meet their efficiency savings targets, as one-off savings such as cuts in management costs and pay freezes lose their effect, Monitor said.
Last year savings were 21% lower than planned and Monitor says foundation trusts are now revising down their future expectations.
The overall reduction in clinical staff over the next three years forms the basis for foundation trusts predicting a 6.4% recovery in profitability by 2015-16.
Royal College of Nursing policy director Howard Catton described the foundation trust’s plans as a “classic example of boom and bust, yo-yo approach to workforce planning”.
“We have to move away from this, it’s not sustainable for the future,” he warned. The Francis and Keogh reports crossed the Rubicon in terms of making nursing cuts a patient safety issue.”
A Department of Health spokeswoman said there was often a small drop in workforce figures in April as fixed-term contracts came to an end.
She said: “There are over 5,500 more clinical staff in the NHS since May 2010, while the number of admin staff, managers and senior managers has fallen by nearly 21,500.”
Extract from Monitor annual plan review (page 10):
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