News Roundup [abridged Versions Appear In The Paper Journal]

Three quarters of NHS trusts in deficit are cutting staff

BMJ 2006; 332 doi: (Published 02 February 2006) Cite this as: BMJ 2006;332:256
  1. Adrian O'Dowd
  1. London

    Just over three quarters of the NHS trusts that have acute financial problems have reduced their staff to try to balance the books. This is one early finding, published last week, from a survey of trusts in deficit by the NHS Confederation, the representative body for NHS organisations. Doctors' representatives are worried that care of patients is suffering and good working relationships with managers could be damaged.

    The survey included responses from 35 chief executives out of the 63 trusts that are under government scrutiny because of their financial troubles. Of the respondents, 29 (82%) had imposed a vacancy freeze, 27 (78%) said that they had made staff reductions as a short term measure, 18 (52%) had temporarily closed wards, and 13 (38%) had cancelled services or restricted eligibility for services.

    The Department of Health announced last week that after visits to the 63 trusts by accountancy firm KPMG for preliminary assessment, it was going to send in “turnaround teams” of financial specialists to 18 trusts that needed urgent help. The government is worried about the estimated £620m ($1.1bn; €910m) deficit that the NHS in England is expected to have by the end of the current financial year.

    As the NHS Confederation announced the results of its survey, it warned that more services will have to be cut if trusts with serious financial problems are forced to repay debts too soon. And it said that the government should restructure the debts. Gill Morgan, the confederation's chief executive, said, “The causes of the current problems are deep rooted and long term. Many of them relate to changes in accounting rules. It is wrong of the government to simply blame NHS managers.”

    All of the trusts in question have now developed comprehensive recovery plans, she added, saying, “Now they need our politicians to have the courage to allow them to make some painful decisions and review the policies that are making life harder on the ground.

    “We should start with restructuring the debt. It is simply not viable for long term historic debt to be paid off in 18 months without cutting services. Then we need to review local hospitals and services and take difficult decisions that will benefit patients in the long term.”

    The survey also showed that 34% of the chief executives thought workforce costs should also be reduced as a long term solution to NHS finances. A spokesperson for the BMA said, “It is extremely worrying that NHS trusts are saying they will have to cut staff numbers in order to balance their books. It is hard to imagine that these cuts will not affect patient care.

    “Despite increased NHS funding there is still a shortfall of resources to meet patient expectations. While the BMA welcomes offers of support in financial management, we are concerned that aggressive bully boy tactics will only lead to ill feeling and put at risk partnership working between doctors and managers.”

    The confederation's full survey was due to be published on 2 February, after the BMJ went to press.

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