Peter Carter on the government’s proposed ‘efficiency savings’ and how you can get involved in the RCN’s new campaign, Frontline First.
We are all well aware of the gloomy financial clouds that hang over the public sector in every corner of the UK. The new government has confirmed that billions of pounds of “efficiency savings” will need to be found in the NHS over the next few years.
In England, the health secretary Andrew Lansley has pledged that spending on the NHS will increase in real terms for the next five years. However, we believe that this is unlikely to keep up with the growing demand. This is why the Royal College of Nursing has launched a new campaign - Frontline First. As well as identifying where cuts are likely, we will expose waste in the system and celebrate nurse led innovations that are saving money while giving patients the care they deserve.
‘Local NHS organisations appear to be adopting a shortsighted slash and burn approach to jobs - this will have a disastrous effect on the quality of care provided’
After receiving information from members working on the ground, the RCN has examined board papers from hundreds of NHS organisations in order to determine the number of posts already earmarked for cuts. We have found that some 9,973 posts (the equivalent of the amount in a large teaching hospital) have already been the subject of discussions about cuts.
These cuts will primarily be through vacancy freezes, not replacing staff that leave, downgrading job roles and ceasing the use of agency and temporary staff, although we believe some organisations will also make redundancies. Several organisations are also reviewing skill mix so that non-registered staff provide more care and some trusts are actively “rebanding” or “downbanding” posts in order to secure savings.
We happen to believe the government when they say they want to protect the NHS and the care it provides. However, local NHS organisations appear to be adopting a shortsighted slash and burn approach to jobs - this will have a disastrous effect on the quality of care that is provided as well as the range of treatments available.
We are now asking nurses throughout the UK to use our campaign website to help us expose where dangerous cuts are being made in the NHS that threaten patient care. We want everyone, from members of the public to members of parliament, to realise the scale of the cuts and the extreme pressure this will put on staff working on the frontline.
However, amid the doom and gloom, we believe that there is real hope. We believe that too few organisations are taking innovative approaches to finding efficiencies such as consulting with staff and implementing a clinical evidence based configuration of services. We believe that frontline staff know where the efficiencies can be made and, because of that, NHS organisations should engage with staff if they wish to ensure better care. Through the Frontline First campaign website, nurses from across the UK can share examples of where waste and innovation, as well as cuts, are taking place in the NHS.
We know waste is sadly a fact of life in the NHS, and also that innovative solutions could go a long way in helping to increase efficiency - for example, we have heard that one trust has spent £40,000 on posters telling people to smile in a bid to alleviate mental health problems. We have also heard of cases where general waste is being incinerated unnecessarily at considerable cost to the hospitals involved.
Identifying where waste is happening and championing the changes needed to stop cash haemorrhaging out of the NHS will be one way that nurses can help to increase efficiency in the NHS. They can also go one step further and play a key role in introducing innovative ways to help keep the cost of care down.
Innovations and improvements are essentially about doing things differently. They are about thinking differently about the care or services that you provide as a nurse and changing the way this is done in order to improve patient experience and health outcomes.
Innovation can be as simple as ensuring that supplies that are due to go out of date imminently are redistributed to another ward instead of being wasted. It can also include the introduction of a new role, new technology or the “redesign” of a service.
We acknowledge that these are challenging times for public sector workers. However, it is often “when the going gets tough”’ that colleagues are most receptive to ideas about how things might be done differently.
By championing innovation in your workplace, you will be demonstrating the important role nurses can play in making efficiency savings and ultimately protecting frontline services.
We are now asking nurses throughout the UK to tell us what’s going on where you work. Where are you seeing the cuts? Where have you seen the waste? What have you done differently to improve the way you work and the way care is delivered?
If you give us the answers to these questions, we can hold local decision makers to account and stop the cuts that we know will hit frontline services.
The Frontline First campaign site can be accessed at rcn.org.uk/frontlinefirst
Peter Carter is chief executive and general secretary, Royal College of Nursing