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Welsh healthcare cost-cutting letting patients down, warns Royal College of Nursing

Cuts to specialist services could impact on patients in Wales, warns the RCN (photo: William Warby)

Nursing is often considered an occupation where its employees are overworked and underpaid.

But the Royal College of Nursing says patients are being let down through the latest ‘short-sighted cuts’ to services in Wales.

Trusts across Wales are slashing specialist nursing care for conditions such as cancer and diabetes, detracting from the quality of patient care, the RCN has warned.

Furthermore it is feared this cost-cutting could be counter-productive, as a decrease in the quality of patients’ health and happiness could force people into hospital, ultimately costing the NHS more money.

There are currently 21 specialist nurses in Wales – seven fewer than in 2009.

An RCN survey of nearly 800 specialist nurses revealed that:

  • Nearly two thirds (62%) are seeing cutbacks in their specialist area
  • More than a third (38%) are being asked to work outside their specialist area to cover staff shortages, jeopardising their time with vulnerable patients
  • Almost 80% say financial pressures within their Trust are having a negative impact on patient care
  • More than one in ten (11%) say they are now at risk of redundancy
  • More than half of cancer specialists (53%) are aware of cuts, with nearly one in 10 (9%) currently at risk of redundancy

Now the RCN is calling for Trusts to invest in nurse-led schemes that keep people out of hospital, save money and improve patient care.

The RCN study Specialist Nurses: Changing Lives, Saving Money details how specialist nurses – or nurse consultants – play a unique role within the health service. Currently the strong relationships between specialist nurses and patients, not to mention the nurses’ medical expertise, mean patients are often diagnosed and treated more efficiently than would otherwise have been the case, as well as having excellent continuity of care.

Analysis for the RCN by the Office for Public Management revealed one scheme in Cheshire generated a £23 cost benefit for every pound spent on specialist nursing, as well as significant improvements in patient care.

If this is taken away, says the RCN, it could impact negatively on people with serious conditions such as cancer, diabetes and multiple sclerosis.

Director of RCN Wales Tina Donnelly said: “There are currently 21 nurse consultants in Wales. This is a drop of 7 posts since 2009.

“Consultant nurse posts were first established in 2000 in Wales. They are central to the process of health service modernisation, helping to provide patients with services that are fast and convenient.

“In addition, the nurse consultants are responsible for developing personal practice, being involved in research and evaluation and contributing to education, training and development.

“For the profession, a decrease in the development of nurse consultant posts in Wales leaves reduced opportunities to retain experienced nurses in clinical practice.  For the patient, nurse consultants provide a rich resource of high level clinical leadership and research of policy into practice which is unique to the role.”

Consultation with other leading health organisations, such as Macmillan Cancer Care, Epilepsy Action and Parkinson’s UK, reveals that more than 62% have seen cutbacks in specialist nurse services in their field.

Cath Lindley, general manager for Macmillan Cancer Support in Wales, said: “We know that the NHS in Wales is under a lot of pressure to cut costs, but NHS managers need to make good choices on how they respond to this. They should ensure specialist nurses are using their skills to make patients happier and healthier so they spend less time in hospital – therefore saving the NHS money.

“If the NHS is to deliver person-centred care and meet the financial challenges, one thing it can’t afford to do is to cut specialist support. It is proven that clinical nurse specialists improve patient care and save the NHS money in the long term by keeping patients out of hospitals, where they often don’t need to be if they are given the right care and support.”

This issue has come to light just as nurses overwhelmingly backed a vote of no confidence in health secretary Andrew Lansley over his controversial NHS reforms.


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