NURSES and other vital health workers face the sack within weeks, Jim Mackey, the chief executive of NHS Improvement, the body which is now in charge of the NHS, has warned.
Interventions currently being taken by regulators to ‘regain control’ of NHS finances could result in some providers having fewer clinical staff ‘in the coming weeks’, HSJ (Health Service Journal) reports in this week’s issue.
HSJ reports that efforts to reduce the ‘provider deficit’ will focus on 30-40 trusts where the pay bill either increased substantially last year, or who have planned for growth in 2016-17.
In an exclusive interview, Jim Mackey, chief executive of NHS Improvement, told HSJ that trusts exceeding the 1:8 nurse to patient ratio will be told ‘we can’t afford that’. Mackey said trusts getting bailouts has ‘almost become the norm’ and his team is in the process of exploring where growth that took place last year can be ‘corrected’, and planned growth for 2016-17 ‘mitigated’.
He said ‘it is possible’ this will lead to fewer clinical staff on wards, adding: ‘I can think of a couple of providers that went beyond the safe staffing requirement. A lot of providers ended up using bank and agency (staff) to try and get close to the safe staffing recommendations, but I’ve met with some that went even beyond that 1:8 ratio from a nursing point of view.’
Mackey said NHS Improvement would scrutinise pay costs across the entire provider sector, not just acute trusts. The NHS provider sector reported a deficit of £2.45bn in 2015-16, leaving the Department of Health with a huge financial hole to fill in its year-end accounts, which are due to be published this month.
The sector has planned for a deficit of £550m this year, but regulators expect this to reduce to £250m. Mackey said it is too early to say how much of the pay growth was unjustified, adding: ‘By the end of July we want to be really clear what that means for each provider’s plan, so how much of it can be corrected and what’s the timescale.’
The process, he claimed, is about ‘just restoring good discipline, good governance, and good processes that have continued to exist in our best providers’. There is expected to be an announcement later this week, dubbed a financial ‘reset’, which will outline the consequences for providers that fail to ‘improve’ their financial situation.
Mackey went on: ‘When everyone says activity went up 2 per cent, therefore cost needs to go up, no it bloody doesn’t.’ He went on to state that a number of NHS ‘providers’ are ‘on the edge of going out of business’ and close to not having enough cash to pay staff. However, he warned, there will be no ‘bailouts’, insisting: ‘There isn’t the cash there.’
He went on: ‘The vast majority of providers are working extremely hard to be part of the solution and in the last year we’ve made a great deal of progress towards getting the provider side back in balance.
‘From a budget of £110bn for the NHS, providers make up roughly two-thirds of that. There is a whole third of that NHS budget where until now there has not been as much focus in terms of financial discipline.’
