Comment


A cut too deep? EDITOR’S COMMENTwith LOUISE FRAMPTON


THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


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STEP COMMUNICATIONS ISSN No. 1478-5641


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Trusts have been asked to drastically reduce running costs, raising concerns over whether the government will be able to deliver on its plans to tackle the backlog and ‘build an NHS fit for the future.’ Virtual wards, rehabilitation centres, talking therapies and diabetes services for young people are among services identified at risk. A survey by NHS Providers found:


l Nearly half of Trust leaders (47%) said they are scaling back services to deliver tough financial plans, with a further 43% considering this option.


l 37% said their organisation is cutting clinical posts, with a further 40% considering this. l 45% are moderately or extremely concerned their actions will compromise patient experience. l 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.


l Nearly nine in ten (88%) said they don’t have enough funding to invest in prevention. l 81% disagreed that Trusts have sufficient funding to invest in digital transformation.


A number of Trusts are aiming to take out 500 posts or more, with one organisation planning to cut around 1000 jobs; 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. Some of the comments captured in the survey highlight the challenges ahead in delivering the Government’s three “shifts” in services – i.e. more community-based care, prevention, and use of digital technology: “The focus on cuts currently means that we have no capacity to shift from acute to community. There’s no mechanism for re- investment,” said one respondent. Another commented: “Our plan is not to impact quality, patient safety, patient experience and staff wellbeing. But the scale of the ask is such that this is going to be very challenging to achieve.” Healthcare leaders also expressed concern that cuts will exacerbate health inequalities: “So far, we have refrained from things that create health inequalities, but these are likely to be part of discussions to enable longer term financial recovery,” said one Financial Director. Commenting on the survey, Saffron Cordery, from NHS Providers, said: “Let’s 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.” RCN General Secretary and Chief Executive, Professor Nicola Ranger, warned that cutting nurse jobs costs lives. “Wes Streeting will need to decide if this is acceptable on his watch. Reducing clinical jobs and patient services is different from any argument on NHS waste and efficiency. Patient needs go unmet, hospitals become overcrowded and waiting lists grow. Ministers must realise that in the drive for savings it is patients who are paying the price.” UNISON Head of Health, Helga Pile, said: “Ministers shouldn’t be insisting Trusts balance their books, while ignoring the damaging consequences for patient care and a demoralised workforce. The NHS needs more staff, not fewer workers, if delays and waits for patients are to end…Unrealistic demands for efficiency savings are leaving Trusts with no option but to let much-needed workers in finance, estates and planning, as well as nurses, healthcare assistants, porters and other staff go. This is having a ripple effect across the whole workforce, who are left wondering how on earth they’ll manage if their colleagues are no longer there.” The Labour Party states on its website: “Labour has saved the NHS before, and the next Labour government will do so again.” But with healthcare leaders warning of cuts to clinical jobs and services, and insufficient funding to invest in digital transformation or prevention – the cornerstones of change – it remains to be seen how the Government will deliver on its promise. Patients and staff have already paid the price for cuts to the NHS, and now they want change...


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June 2025 I www.clinicalservicesjournal.com 5


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