NHS cost saving plans must be agreed by directors of nursing and have “built-in” assurances that patient safety and service quality will not be compromised, according to latest guidance from the Department of Health.
The DH today published its operating framework for the NHS in England during the next financial year, beginning in April. The document sets out the government’s priorities for the health service during 2012-13 and how they should be achieved.
The framework restated the £20bn savings target that the NHS faces over the next few years. NHS managers are required to find these savings via greater efficiency and productivity, through what is known as the quality, innovation, productivity and prevention programme.
The operating framework highlighted that the NHS was “on track” this year to achieve its QIPP savings objectives but said the health service needed to “build on” this progress in 2012-13 and “start to deliver transformational service change”.
The Royal College of Nursing and other unions have warned, however, that many trusts are simply cutting staff numbers, which risks a reduction in patient safety and quality of services.
In a change from last year’s operating framework, the 2012-13 document stipulates that senior clinicians, and also patient representatives, must be included in agreeing future trust savings plans.
It states: “For 2012-13, we need to build on the progress made in delivering efficient organisations and, through the reinvestment of those efficiencies, start to deliver transformational service change while maintaining the gains already made.
“Where cost improvement programmes are required, these must be agreed by medical directors and directors of nursing, involve patients in their design and include in-built assurance of patient safety and quality.”
RCN head of policy Howard Catton said it was a “positive move to see the explicit expectation that directors of nursing be included in the sign off of changes to staffing and skill mix”, and other nursing resources that might be “diluted to the detriment of patient care”.
But he also cautioned that a trust’s full board must remain responsible for cost saving decisions to avoid clinicians being singled out for blame. “There is a concern if this is an attempt to deploy directors of nursing as a ‘heat shield’ for tough decisions,” he said.