01.02.16
Hospitals told to tackle acute sector funding hole by firing staff
Hospitals across England are being told by health regulators to shed staff in order tackle the acute sector’s funding crisis, despite ministers ordering providers to do the exact opposite.
The order – outlined in a leaked letter sent by Monitor and NHS TDA on 15 January to all of the 214 trusts they oversee – could leave hundreds of nurses, managers and other critical frontline staff at risk of being fired, amid intense concerns from hospital bosses and unions that reducing staff will affect care quality and increase waiting times.
It also comes just three years after ministers backed raising staffing levels in response to the Mid Staffs scandal.
The letter, signed by TDA deputy chief executive Bob Alexander and his Monitor counterpart Stephan Hay, seen by the Guardian, said: “We will be meeting a number of challenged providers this month to agree a set of actions, including headcount reduction, additional to the current plan, with the clear intention of improving the financial position of those individual providers.”
It also told trusts they must reduce their “financial distress” if they want to receive part of the £1.8bn bailout fund that will be made available in April.
In a separate letter from the regulators sent on 22 January, trusts were also told to extend the life of “plant, machinery and equipment” wherever possible to save cash. This could effectively see important equipment, such as CT and MRI scanners, used beyond their working life.
A chief executive of one of the country’s biggest trusts, speaking anonymously to the Guardian, argued: “They are signalling fewer people working for the NHS. What they don’t seem to appreciate is that it’s hands-on business and you need the hands on. If we aren’t careful we will be driving the NHS off a crisis cliff. The reality is that there isn’t enough money going into the NHS for it to do its job properly.”
Despite all acute trusts being in deficit, with some, such as Addenbrooke’s, facing funding holes as big as £60m, healthcare groups have attacked the regulators’ decision to salvage the system by dropping staff.
Richard Murray, the King’s Fund director of policy, said that if trusts start to cut down on headcount, the “impact on patients would be swift”, either through worse quality of care, higher waiting times, or both.
“Three years on from Robert Francis’s report into Mid Staffs, which emphasises that safe staffing was the key to maintaining quality of care, the financial meltdown in the NHS now means that the policy is being abandoned for hospitals that have run out of money,” he said.
The Royal College of Nursing’s director of policy Howard Catton also warned that patients will suffer without the right amount of skilled frontline staff. Fewer workers will only lead to longer and “completely preventable” hospital stays, he said.
But a Department of Health spokesman said the government expects “all parts of the NHS to have safe staffing levels – making sure they have the right staff, in the right place, at the right time”.
At present, hospitals are expected to rack up a major £2.2bn deficit by the end of the financial year, most of which is tied to a £4bn drain on the health system through the dramatic use of agency staff.