NHS Trusts are determined to protect patient safety as a new survey by NHS Providers reveals services are being scaled back and jobs cut as the demands of the NHS financial 'reset' become clear.
With the NHS looking to recover a predicted financial shortfall that reached nearly £7bn this year, Trusts have been asked to drastically reduce running costs while improving performance against key targets.
With the 10-year health plan due to be published in the coming months, nearly half of Trust leaders (47%) surveyed warned they are scaling back services to deliver tough financial plans, with a further 43% considering this option. Virtual wards, rehabilitation centres, talking therapies and diabetes services for young people are among services identified at risk, demonstrating the extremely tough choices being faced by NHS leaders.
Worryingly, over a third (37%) said their organisation is cutting clinical posts as they try to balance their books, with a further 40% considering this. With Trusts told to halve corporate cost growth, 86% of Trust leaders said their organisation is going to have to cut posts in non-clinical teams - such as HR, finance, estates, digital and communications – potentially risking efforts to deliver services, innovate, and improve productivity.
The scale of job cuts is becoming clear with a number of Trusts aiming to take out 500 posts or more and one organisation planning to cut around 1000 jobs.
With further reductions to temporary staffing costs (91%) and a recruitment freeze (85%) also on the cards, the impact of these changes on hardworking and overstretched front-line teams is a major concern for Trust leaders. More than nine in ten (94%) said the steps needed to deliver financial plans would have a negative impact on staff wellbeing and culture at a time when morale, burnout and vacancies are taking their toll and disquiet over pay and conditions is rising.
Now Trust leaders have called on the government to recognise the difficult decisions and competing priorities Trusts face as they try to improve patient services while trying to balance the books.
The survey by NHS Providers, which represents hospital, mental health, community, and ambulance services also found:
- More than one in four (26%) said they will need to close some services (a further 55% are considering this).
- 45% are moderately or extremely concerned their actions will compromise patient experience
- Close to three in five respondents said patient experience (61%), work to address health inequalities (60%) and access to timely care (57%) were most at risk of being impacted.
- Nearly nine in ten (88%) said they don’t have enough funding to invest in prevention.
The interim chief executive of NHS Providers Saffron Cordery said: "Trust leaders will always put patient safety and quality of care first. They're acutely aware of pressures on the public purse, the scale of the challenge they're facing and their duty to make the most of every pound that goes into the NHS.
"They're working hard every day to find efficiencies, cut costs and make savings without compromising safety. They're at the forefront of efforts to shift care from hospitals to the community, from analogue to digital and from treating sickness to preventing ill-health.
"Trust leaders have also heard loud and clear that overspending will not be tolerated and have made major inroads in tackling the huge financial deficit facing the NHS. But let's also be clear: cuts have consequences. NHS Trusts face competing priorities of improving services for patients and boosting performance, while trying to balance the books with ever-tighter budgets. National leaders must appreciate that makes a hard job even harder.
"It's really worrying to hear trust leaders tell us highly valued staff and services including vital work to address health inequalities and prevention could be among the early casualties of budget cuts. These decisions are never taken lightly and will always be a last resort.
"They're committed to working with the government to build a better health service but fear immediate financial pressures could undermine plans to transform the NHS."
View the survey results here.
