RCN condemns government decision to cut ICB nursing posts

Confirmation that integrated care boards (ICBs) will be made to cut expert nursing posts and other roles has been described by the Royal College of Nursing (RCN) as a ‘false economy’ that presents major risks to frontline services.

Health and social care secretary Wes Streeting has today given NHS leaders the ‘go ahead’ for a 50% cut to headcounts in ICBs – including senior nurses.

The government said reforms would see around ‘18,000 administrative posts abolished’ and would save more than £1bn ‘that will be redirected to frontline patient care’.

‘Dismantling years of work’

Patricia Marquis, executive director of RCN England, said the government did not recognise the scale of the problem that the redundancies could bring.

‘Dismantling years of work takes thought and planning, but the government and NHS England have failed to appreciate the scale of the risk or to plan to mitigate these risks,’ she warned.

‘The government’s reforms need people who are not just clinical experts, but also those who know their way around the health and care systems to ensure patients can access the best possible care.’

‘Alive to uncertainty’

Announcing the news at the NHS Providers Conference in Manchester today, Mr Streeting said: ‘From today, I’m giving ICBs the go ahead and the funding for the voluntary redundancy programs that staff have been waiting for.

‘We’re asking ICBs to downsize significantly – having overseen redundancies in organisations I’ve worked in previously, I want you to know I do not take this lightly.

‘I’m very alive to the uncertainty that’s hung over staff for far too long, and I don’t mind saying it’s made me uncomfortable, as it should, because I know we’re not just talking about jobs, we’re talking about people’s livelihoods, and again, that is my responsibility, not yours.’

The government has said the cuts will help to reduce running costs of ICBs, which it says have not previously had a clearly defined role.

‘ICBs will now have a clear and focused purpose as strategic commissioners – a much clearer and sharper role than previously,’ the DHSC said in a statement last night.

The health secretary also confirmed the merger of NHS England into the Department of Health and Social Care (DHSC) would happen within two years, as planned.

‘A complete lack of understanding’

Ms Marquis said the government had failed to recognise and plan for the impact that the redundancies could have on the healthcare system and reflect ‘a complete lack of understanding’ of the work nurses do.

‘Frontline services need more investment, but to do this off the backs of making thousands of experts redundant is a false economy,’ she said.

‘Expert registered nurses working across NHS England and ICBs don’t just run vital public health programmes and oversee care programmes for the vulnerable – they connect the NHS and social care services with one another.’

She also warned that seeing nurses as ‘administrators’ reflects a ‘complete lack of understanding’ of their roles.

‘We now need to see fully detailed plans for how patients will be protected and care will be transformed whilst losing so many nursing experts,’ said Ms Marquis.

‘We also need to see more detail on how exactly this funding will be used to improve services and address challenges like corridor care.’

How will the redundancies be paid for?

Funding for the redundancies is to come from ‘within the existing funding settlement’ for the NHS, the government has confirmed.

But the DHSC said it will ‘not be cutting any investment to the NHS, frontline or backroom’ and that ‘further detail will come in the coming weeks’.

Expansion of women’s health hubs

Despite the redundancies, the government has this week repeated its commitment to expanding women’s health hubs.

Responding to a question from the Liberal Democrat spokesperson for primary care and cancer in Parliament yesterday Karin Smyth, the minister of state of secondary care, said the government was supporting ICBs to keep improving their delivery of women’s health hubs.

‘We have heard from ICBs on the positive impacts that women’s health hubs have on both women’s access to care in the community and their experience.

‘The government is committed to encouraging ICBs to further expand the coverage of women’s health hubs and to support ICBs to use the learning from the women’s health hub pilots to improve local delivery of services to women and girls,’ Ms Smyth said.

In August, the RCN warned that the threat of nurse redundancies and ongoing uncertainty around incoming cuts to ICBs was placing significant strain on the workforce and ‘undermining the delivery of vital nursing functions’.