Monitor’s proposals threaten safe staffing

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2016 Health Care Service Group Conference
15 December 2015

Conference notes with concern the letter sent out in Summer 2015 by Monitor and the Trust Development Authority to all provider trusts in England asking them to take urgent measures to reduce the predicted national £2 billion health deficit. The measures suggested include “to ensure vacancies are filled only where essential”, but does not explain what it means by essential vacancies, or how this will be done.

Conference also notes that at the same time the government sold its remaining shares in Royal Bank of Scotland at a price considerably lower than their purchase value, resulting in a loss of £1 billion pounds of taxpayers’ money, and a supply of cheap share buys for private sector institutions. This is a large sum of money which could, if not handed away, have helped reduce the NHS deficit substantially.

The Monitor proposals put safe staffing levels at risk and would further undermine morale and increase workplace stress, in spite of the serious issues uncovered in the Francis report, detailing the consequences of putting targets and financial issues before safe and effective patient care. Coupled with the suggestion made in the same letter, that Clinical Commissioning Groups should suspend fines on trusts who break eighteen week limits, it would seem that there will be a process of decreasing staff numbers and increasing waiting lists to make the books balance.

ALL health staff are facing increasing workloads leading to stress and poor morale, at a time when staffing budgets are being hit by cost improvement programmes and escalating agency staffing costs.

When challenged on this, Monitor have said that they do not expect trusts to stop recruiting doctors and nurses, but it is difficult to see how significant savings could be achieved without doing just this. Also, non-clinical staff, such as domestics, catering, and records staff are equally vital to the safe running of an NHS organisation, and we have already seen the consequences of cuts to these services, such as increased rates of hospital acquired infection.

Furthermore, there is a risk that in local health economies there will be an expectation that financially more successful foundation trusts will be expected to make proportionately greater savings to subsidise underfunded/poorly performing foundation trusts, which can only reduce quality and staffing in trusts that are doing well.

Conference calls upon the Health Service Group Executive to work with all appropriate bodies, to express their condemnation of this threat to NHS staffing and services in the strongest possible terms, and to work with branches, regions and community groups to identify, publicise and oppose job cuts and privatisation which may be made as part of trusts’ responses to the Monitor/TDA letter.