NHS hospitals in England are being instructed to reduce staffing levels in a bid to rescue the health service from a severe funding crisis, putting thousands of nursing and management jobs at risk. The directive from regulators Monitor and the NHS Trust Development Authority (TDA) marks a stark reversal of the policy introduced after the Mid Staffs scandal, which prioritised increasing staff numbers to improve care quality.
The move comes as NHS trusts face a projected combined deficit of £2.2bn by the end of March. Some hospitals, such as Addenbrooke's in Cambridge, are losing £1.2m a week and could end the year £60m in the red. St George's in south London expects a deficit of £46.2m. To save £1m, a trust would need to cut 25 nurses, according to the King's Fund thinktank.
In a letter sent on 15 January, regulators told all 241 NHS trusts to take “headcount reduction” and other actions to reduce financial distress if they wished to access a £1.8bn bailout fund available from April. The letter, signed by senior officials Bob Alexander and Stephen Hay, stated they would meet with challenged providers to agree additional measures including staff cuts.
Health unions and policy experts have warned that reducing staff will harm patient safety and increase waiting times. Richard Murray of the King's Fund said the policy abandoned the lessons of the Mid Staffs report, which emphasised safe staffing as key to care quality. Howard Catton of the Royal College of Nursing added that fewer skilled staff would lead to longer hospital stays and preventable harm.
Shadow health secretary Heidi Alexander accused the Conservatives of breaking their election promise to ensure adequate staffing. The NHS's overspend is largely driven by a £4bn annual bill for expensive agency staff, which regulators are also seeking to curb through extended use of existing equipment.
