Uncertainty around ICB cuts ‘harming and undermining’ nurses

The threat of nurse redundancies and ongoing uncertainty around incoming cuts to integrated care boards (ICBs) is placing significant strain on the workforce and ‘undermining the delivery of vital nursing functions’, the Royal College of Nursing (RCN) has warned.

The government has today been asked by the RCN for a ‘renewed conversation’ on its planned cuts for ICBs and to protect the role of a chief nursing officer for every ICB.

Alongside plans to abolish NHS England, the government announced earlier this year that ICBs would be required to reduce running costs by 50%.

But since then, the RCN argued that ‘most of the nursing staff affected still have no definitive information about how these changes will impact their roles’.

In a new report published today, it said: ‘For several months, nursing staff working in commissioning bodies have faced growing uncertainty regarding the long-term future of their roles and teams due to delays to wider system reforms.

‘This continued lack of clarity is undermining the delivery of vital nursing functions and placing significant strain on the workforce.’

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The situation has caused ‘considerable stress and anxiety among nursing staff working in frontline commissioning roles’ and the ‘threat of redundancy is harming the nursing workforce’, the college warned.

It added that no nursing role should be cut without ‘thorough assessment of the impact on patient safety, care quality and equality’.

In addition, the RCN said it wanted assurance from the government that a chief nursing officer post would be retained in every ICB – reserved for a registered nurse as part of the executive team – to provide ‘crucial strategic leadership’.

Amid the uncertainty for nurses working within ICBs, the RCN said those among the profession also felt that their skills had been ‘ignored’ as reforms are made and that patient safety was therefore being put at risk.

The RCN has urged the government to meet for talks on the cuts to ICBs and the direct involvement of nursing staff in plans for the future of local health services.

‘There must also be time to provide greater clarity to staff and work to ensure that the cost of reform will not be paid by a fall in health and care standards,’ it added.

Executive director of RCN England Patricia Marquis said: ‘Nursing staff in ICBs have led the way in planning and commissioning local health care.

‘They are not only central to the safe delivery of services for patients, but also in designing the services of the future.

‘At a time of huge transformation, their expertise is priceless and we cannot afford to lose them in a cost-cutting exercise.’

She added: ‘We need nurses influencing the health care in every ICB and that must include a chief nurse with a seat at the top table.’

Ms Marquis warned that excluding nurses from discussions about the future ‘devalues the profession’ and risked the successful delivery of the government’s 10-year plan for the NHS.

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In its report today, the RCN highlighted testimonies from nurses working with ICBs about the importance of their role and the risks associated with cuts.

One said: ‘Most people don’t know our role exists – but it would be noticed if it didn’t.

‘We advocate for patients and communities during the most horrific incidents and make decisions that people don’t want to think about.

‘Not everyone in my role is from a clinical background and I’m proud to use my clinical experience to ensure that patients are at the heart of every decision when planning for, responding to and recovering from incidents.’

As NHS England is abolished and merged into NHS England, the RCN said the Department of Health and Social Care (DHSC) must also ensure a government chief nursing officer (CNO) post is created, with parity to the chief medical officer (CMO).

The government CNO must participate in ‘strategic decision-making’, report to the prime minister and health secretary, and ‘share the key responsibilities of public health and emergency planning with the CMO office’.

An NHS spokesperson said: ‘NHS England is not prescribing the composition of local boards, but clinical leadership at all levels of the NHS remains vital to improve care – with patient safety and experience our priorities.

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‘The Model ICB Blueprint, developed by a group of ICB leaders including chief nursing officers, is the first step in a joint programme of work to reshape the focus, role and functions of ICBs as we also reshape regions, the centre and our broader approach to the operating model to reduce the management costs of the NHS so more money can be spent on the frontline.’

A Department of Health and Social Care spokesperson said: ‘We have underlined the need for trusts and ICB’s to cut bureaucracy and duplication to invest even further in the frontline, so we can support hard-working staff and deliver a better service for patients and better value for taxpayers’ money.’

They said that ‘efficiency savings’ were in part what had ‘allowed this government to accept in full the recommendations of the pay review bodies to award NHS staff an above inflation pay rise for two years in a row’.