Sunday, 26 August 2012

Obfuscation over Getting Tougher, Fitter, and Possibly Poorer Working for the NHS

There was a flurry of related NHS people stories last week. The first to catch my eye was the report from the Health and Social Care Information Centre on the comings and goings of different staff during the year May 2011/12. It seems that some 89926 people left the NHS in England, but only 77522 of these posts were filled. Whilst this 12000 shortfall is significant, the overall headcount of professional employees has reduced by almost 20000 people since September 2009. In addition, those people the Department of Health likes to call ‘NHS infrastructure support workers’ also fell by about 20000 from 236000 to 216000 over the same period. Managers and senior managers lost 5000 and 2000 positions respectively.

Of interest to this School is that these figures reveal qualified nursing, midwifery and health visiting staff posts have reduced by almost 5000 in the last two years. Yet when Anne Milton, ex Grammar School girl and fully qualified nurse, now Health Minister, was asked about these reductions she said there are 2400 more clinical staff working in the NHS than there were two years ago in May 2010, including over 3700 more doctors, and over 900 extra midwives’ and ‘funding will increase by £12.5 billion over the next three years, protecting the NHS for the future’ she concluded. In response Peter Carter of the RCN, said ‘The RCN will continue to oppose job cuts locally and nationally on behalf of our members and the patients they care for.’

Such sterling words will be music to the ears of Dr Graham Henderson (husband of Anne Milton) as he works in the field of community medicine – and it seems the community is getting sicker. The Insight Research Group published a report last week; The Austerity Britain Report which looked at the impact of the economic recession is having on people. The study’s participants were GPs working across the UK who were asked about the health of their patients and how this had changed over the past 4 years.

The GPs felt that worries over financial security coupled with many people working longer hours had led to a 77% increase of new mental health cases over the last 4 years (54% reported the greatest increase being anxiety, 46% felt it was depression). Additionally, 64% of the GPS reported patients drinking significantly more alcohol, whereas there had been a 38% increase in requests for help to give up smoking (cost being the most often reason cited). Likewise there was a reported 17% increase in patients requesting terminations due to financial concerns and a 34% increase in the numbers of patient putting off starting a family until their financial security improved. 60% of patients were cancelling sporting activities due to financial concerns and 54% cancelling gym membership due to work demands.

Such big increases don’t appear to be reflected in the sickness rate of NHS staff. The NHS Information Centre has published annual data for the level of sickness absence among health service staff, showing an overall rate of 4.12% for 2011/12 compared to a rate of 4.16% in 2010/11. I found it interesting that despite the continuing bad news about the economy, sickness rates in the NHS have only fallen by this tiny amount, nothing to do I suspect with the introduction across many parts of the NHS of more punitive sickness/absence policies. However, 0.4% is still a massive 15.56 million day lost to sickness.

Unfortunately for some NHS workers the misery doesn’t stop there. The South West Pay, Terms and Conditions Consortium which employs some 68000 NHS workers last week published its ideas for making further savings. They are suggesting that if the average sized hospital were to cut the pay of staff by 1% across the board, it would produce annual savings of around £1.4 million; adding another hour on top of the contracted 37.5 hour working week (for no extra cash) would lead to gains of £2.6 million; and by reducing annual leave entitlement by 2 days would generate over £750000 a year. The Foundation Trust Network, which represents the most financially successful hospitals in England – including members of the South West consortium – said 'that given the scale of the savings required in the NHS it was understandable that the time has come for some trusts to explore all their options’. Whichever way this turns out it is not good news for the education sector, already suffering because of the changes to university fees and bursary arrangements.

Perhaps slightly ironically, I’m off to Sweden in a few hours to present at a European conference on how a more effective relationship between the NHS and Universities can improve the educational preparation of nurses. Just time for a cup of tea I think before I go. Ho hum as they say.