NHS leaders have written to the health secretary, warning that continued uncertainty over the funding for community services risks creating a ‘funding cliff edge’ which could lead to school nurse numbers being ‘slashed’.
In their letter to Steve Barclay, members of the NHS Confederation called for clarity over the funding mechanism that provides the salaries for staff providing community services from April.
The NHS leaders warned that if any potential pay rise for NHS staff was not quickly passed onto district nurses, school nurses, and health visitors, there would be an impact on the quality of services that these staff can deliver.
This comes as health unions, including the Royal College of Nursing, continue to take part in ‘intensive’ pay negotiations with the Government over the 2021-22 pay deal which had lead to months of industrial action.
However, since the majority of NHS community health services are commissioned by local authorities rather than by NHS England the NHS Confederation remained concerned that the there is no proper mechanism to ensure that these contracts properly reflect pay in the wider NHS.
In the letter, the health leaders wrote: ‘Over the years however the mechanism for ensuring that these public health contracts properly reflect the NHS pay awards approved by the government has proved problematic.
‘Funds to cover the government’s announcements of pay award for these key members of NHS staff do not follow as clearly as they do through the core NHSE route nor have local authorities received the funding to pass through via the public health contracts they are commissioning.’
The NHS Confederation also warned that without a wage adjustment for community healthcare professionals, this would risk ‘school nurse numbers being slashed and sexual health clinic closures.’
Sharon White, chair of the School and Public Health Nurses Association (SAPHNA), told Nursing in Practice that if there was no uplift to the Public Health Grant (the funding mechanism for community services), this would be a ‘significant real terms cut’.
Ms White added: ‘Local authorities will then have tough decisions to make and school nursing will be at risk of cuts. School nursing, like all nursing, is struggling to recruit and retain. However, specifically its not attractive any more as the bulk of their time is spent fire fighting rather than stopping children falling into the fire in the first place.’
The NHS Confederation is now calling for an ‘urgent commitment’ to central funding for the salaries of NHS staff delivering local authority public health contracts to be delivered as part of a lasting solution.
Matthew Taylor, chief executive of the NHS Confederation, said: ‘Community services are absolutely essential in keeping people well at home and in their community and preventing demand on other parts of the healthcare system, but leaders are having to do the impossible, planning services with no certainty on the funding they will have available to pay their staff for any salary increases come April.
‘Without action we are condemning patients, including young children, to lengthy waits and storing up problems in GP practices, A&E departments and other urgent and emergency care services that could have been dealt with earlier in the community because of service and staff cut backs.’