05.08.15
Safe staffing might cost money ‘the NHS just does not have’
Monitor’s call for FTs to “look again” at their finance plans and to scrap ‘non-essential’ posts highlights the clash between delivering safe staffing levels and the true financial picture, a legal expert has told NHE.
Bruce Potter, head of the health and social care team at law firm Blake Morgan and part of the advisory team acting on the dissolution of Mid-Staffordshire NHS FT, said: “What is overwhelmingly clear is the real and possibly insoluble conflict between introducing real cost savings, whilst delivering the massive service improvements set out in the Five Year Forward View.”
He added that the recent tension between NICE and NHS England on safe staff level guidance shows just how tricky this issue is, “and remember this is just to achieve a safe five-day service”.
The British Medical Association (BMA) added that Monitor's warning on NHS finances highlights the urgent need for answers on seven-day services.
Dr Mark Porter, BMA council chair, said it is “simply wrong” to expect doctors, nurses and other NHS staff already delivering weekend care to deliver more without the extra resource urgently needed.
“If trusts are to face an even greater squeeze on funding and staff then the only way to increase consultant presence across seven days is to reduce the number of senior doctors providing elective care during the week,” said Dr Porter. “If this is what the government aims to do as part of making the NHS a “truly seven-day service” then it should be honest with patients and doctors and say so.”
“Monitor’s blunt call for trusts to do more to address projected deficits, coupled with the only essential hires message, highlights the clash between delivering safe staffing levels and the hard truth that putting that staff in place costs money the NHS just does not have,” said Potter.
“Staffing is the largest cost the NHS has to fund, but keeping staffing at safe but affordable levels while that service change is delivered is shaping up to be one of the biggest challenges facing the NHS.”
In his letter sent to all FTs in deficit, Monitor’s chief executive David Bennett said that the NHS is “facing an almost unprecedented financial challenge this year”, adding that no stones must be left unturned in their “collective efforts to make the money we have go as far as possible”. This includes reviewing staffing to make sure “only essential” vacancies are filled.