Government ministers have argued that the £20 billion cut in the NHS budget would not affect front line services. Yet, between May 2010 and September 2012 whilst the number of managers was reduced by 18 per cent and the number of clerical and administrative staff declined by 10 per cent, a consequence has been an increased administrative load on doctors and nurses. If the administrative burden does not also fall, the report warns, there is a risk that front line staff will be diverted to form filling.
Reorganisation has compounded the problem. Commissioning is becoming more complex; for example, child health services are now commissioned by eight different parts of the system, including local authorities. Providers and commissioners will need to coordinate and build working relationships with more organisations than previously, which inevitably takes time and increases the administrative load. The number of commissioning organisations is also increasing; 211 clinical commissioning groups (CCGs) are set to replace 152 primary care trusts. There will also be a greater number of local bodies involved in providing health care, with health and wellbeing boards, local Healthwatch and more CCGs than there were primary care trusts.
There is already evidence that cuts in spending have driven some hospitals to dangerously low levels of staff, putting patient lives at risk. The Royal College of Nursing has identified 61,276 NHS posts which have either disappeared or are set to go as a result of cuts in spending and warn that the NHS is "sleep walking into a crisis." Nurses say that they "do not have enough staff to deliver good quality care. Demand for services is continuing to rise, however staffing levels are being slashed."
Dr Peter Carter, Chief Executive & General Secretary of the RCN, welcoming the Confederation report, said that nurses “have been telling us for several years that they are forced to spend too much time filling in forms, ticking boxes and duplicating information." An RCN survey in 2012 found that 53% of nurses said that clinical information systems were duplicating paper records.
It is time the government abandoned the pretence that cuts in NHS budgets can be managed without impacting patient care. It is putting patients at risk.