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'You can help us stop dangerous frontline cuts'


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

Peter Carter is chief executive and general secretary, Royal College of Nursing


Readers' comments (4)

  • No Peter, YOU can help us stop dangerous frontline cuts by getting a backbone and standing up for Nurses for once, DEMANDING that there are no frontline cuts, putting an end to job freezes, sorting out our working conditions and pay? These things ring a bell?

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  • cuts have been happening for the past year and will continue jobs devalued vacant post frozen personel not replaced with the expectation of do more with less resources and if a mistake is made you carry the accountability the nursing profession has taken on a diverse range of roles in modern times to improve patient care but this is not a valued trait other professional typically make financial or resource demands prior to any change in role we need to learn how to say no maybe then we will be of value

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  • With regard to waste in the NHS. I work in a nursing home, until a few weeks ago our Care Plans consisted of one A4 size thin cardboard on which we wrote on both sides: the problem encountered ; what we would do about it and the hoped for result. this was in full view of all trained staff and proved to be a satisfactory way of caring for our patients. Now, we have a thick plastic folder with 6 o7 dividers and, at the last count, 67 pages for every patient, others are added when one page is full. these are kept now in a locked file so we have now to look up all this gumph to find out any changes in treatment that might have occurred since we were last on duty.

    The medication chart was on a similar card for each patient, we have 20 patients and 68 medication charts - all in triplicate. If a patient refuses a tablet or one is dropped we are required to write down the circumstances of the refusal, place it in a small plastic bag then into a large plastic receptacle for some-one ( I have no idea who) to check it and dispose of it. (I wonder if this anonymous person might pinch an aspirin or two)

    The number of dressings supplied - mainly for the prevention of bed sores is frankly unbelievable. I have been a theatre sister and sister in charge of a surgical ward, never have I seen the number of dressings that we are supplied with - all on the NHS.

    Apart from all this waste of paper and dressings is the waste of nursing time that should be used in caring for our patients used instead filling in useless answers to irrelevant questions. It seems that common-sense has been deleted from any-one's vocabulary.

    And does this supply better care for our Patients? Most decidedly not, we don't have time to chat to any of them and everything is done in a hurry and, more importantly, the nurses are overworked and tired out.

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  • I'm afraid I don't agree with Peter Carter and the RCN that the NHS is safe in this government's hands (He says 'We happen to believe the government when they say they want to protect the NHS and the care it provides'). All the evidence points to the motivation for these radical changes being to privatise our flawed but fundamentally ok system in order to generate profits for individuals. This is being done worldwide - so why not include the UK too? As health is essential for all of us, it makes a great money-spinner! This may not be happening instantaneously but all provider organisations, according to the White Paper on so-called reforms, will be private or run as social enterprises which are easily convertible to private ones. GPs don't have the resources to do adequate commissioning and so they will be forced to employ expertise from the private sector. We need to protest about this in great numbers to our MPS NOW before these changes are ratified by Parliament and the NHS is lost forever.

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