Hundreds of doctors and nurses’ jobs could be scrapped and maternity and A&E services scaled back to meet the government’s “eye watering” NHS savings, a new report has revealed.
A survey of trust leaders by NHS Providers found clinical jobs have already been slashed or are under threat, while outpatient services such as diabetes clinics, rehabilitation centres and talking therapies are at risk of being reduced.
Two trust leaders also said they were considering reducing maternity or emergency departments from multiple hospitals in order to maintain safety and meet the government’s savings demands.
Another trust is cutting end-of-life and palliative care beds in the community, restricting stop-smoking services and working to reduce hospital referrals. One trust chief said they were already “restricting” non-emergency care and surgeries, while 600 clinical roles have been axed at another trust.
The NHS, which is facing a £6bn to £7bn deficit, was allocated £22bn over two years by the government in the last budget. However, this financial award came with strict efficiency-saving requirements.
Interim chief executive of NHS Providers, Saffron Cordery, said: “Most of the money that was allocated to the system was already spoken for. So whilst that money feels like a lot of money and it is, the demands outstripped the supply of finances there, and there’s very little money left to invest in the measures to tackle these challenges.”
“These [savings targets] are at eye wateringly high levels. This comes on the back of a year-on-year focus on efficiencies and trying to tackle that high demand. So, I think it is fair to say that it’s going to be extremely challenging.”
“Politicians are going to have to give trusts air cover locally and nationally when they need to make some changes, because even if trusts aren’t cutting services or closing services, they may well be moving services.
“Moving a maternity service or changing an A&E is an incredibly controversial thing to do. We know that that controversy is there, and so we need the political will as well to follow that.”
The survey, which ran last month, included responses from 160 NHS chief executives, chairmen and other board executive directors. These cover 114 trusts in England and account for 56 per cent of the sector.
Royal College of Nursing, General Secretary and Chief Executive Professor Nicola Ranger, warned:“Cutting nurse jobs costs lives and Wes Streeting will need to decide if this is acceptable on his watch….Ministers must realise that in the drive for savings, it is patients who are paying the price.”
The poll found 47 per cent of leaders are making cuts to services, with a further 43 per cent considering this option.
More than a third, 37 per cent, said their organisation was cutting clinical posts to balance their books, with a further 40 per cent considering this.
More than nine in 10 leaders, 94 per cent, said their plans would have a negative impact on staff wellbeing and the culture of their organisation.
One trust chief executive said: “It’s really difficult to find a way to protect, to safeguard patients, arguably to strengthen safeguards and to deliver the financial efficiencies, like others, we’re taking difficult decisions
“We’re having conversations about moving away from local provisions to asking patients to travel 20 to 30 miles for care now, but on the basis that that travel will mean that their care will be delivered in a better environment, will be safer, and faster. We provide a number of maternity services. It’s an opportunity to bring those together to standardise them.”
“We are restricting access now to planned [non-emergency] care. We’ve got a series of services which are unfunded, and we’ve written back to NHS England to say we no longer want to provide those.”
Another said: “Demand has gone up across all ages by 10 per cent in my services on the year before…I think the differences this year is they’re [the savings targets] are eye watering… at the moment, I don’t know how I’m going to do it.”
The trust chief also called for a reform of the system, which allows private providers with a local NHS contract to provide services nationally, which it said was leading to patients “queue jumping”
Talking about their maternity services, a trust chief said they were considering amalgamating services.
“So I mention maternity, we’ve got an ED with only 200 beds. So we’re going to have to think about what we do with that because it’s not just that we pay a lot of money to run two Maternity services…So how do we reduce costs and be able to take some brave decisions?”
A Department of Health and Social Care spokesperson said: “We invested an extra £26 billion to fix the broken health and care system we inherited, and through our Plan for Change, are determined to tackle inefficiencies and drive-up productivity in the NHS.
“We have underlined the need for trusts to cut bureaucracy to invest even further in the front line, so we can support hard-working staff and deliver a better service for patients and taxpayers’ money.”
