Whistleblowing doctors and nurses have raised concerns at the loss of more than 400 staff, with 30% cuts at consultant level, which they say will heap extra pressure on “already-frantic clinicians”.
Last year Norfolk and Suffolk NHS Foundation Trust (NSFT) announced financial constraints meant it would have to find 20% savings across the organisation by 2016.
A radical redesign of services has prompted widespread criticism from the British Medical Association, the Royal College of Psychiatrists as well as staff and patients.
Concerns raised include:
– Accusations of impossible and unsafe working conditions for clinical staff
– Serious concerns raised over patient safety in the wake of unprecedented cuts
– Medical staff are still unaware of their new job descriptions despite the changes coming into effect on Monday
– Chief executive Aidan Thomas’s decision to step down at a time of immense change across the organisation
In a bid to create five new local teams for Suffolk the majority of clinicians had to re-apply for their jobs. But with two working days until the changes come into effect, many members of staff, including consultants, say they do not know what their new roles will be.
One whistleblower, who works on the front line, said: “Mistakes will happen, and we all know the consequences in this line of work.
“None of us wants to be the person who makes the mistake which results in harm to another person.”
Expressing their concerns, the Royal College of Psychiatrists wrote to NSFT medical director Hadrian Ball after 20 consultant psychiatrists met in Bury last week.
The letter from Dr Laurence Mynors-Wallis states: “I am writing urgently to you today because of the fears, expressed by all the consultants who attended, that the planned reorganisation of services does not safeguard patient care or safety.
“Consultants said, not only do they believe that the staffing numbers proposed for the new teams are insufficient to provide satisfactory care, but also they have serious concerns about the skills and experience of staff being appointed to new teams.
“Concern was expressed about a lack of clarity about responsibility and accountability.
“The consultants at the meeting who included those who had been involved in the service development were unanimous in their view that there had not been meaningful engagement with consultant staff.
“We were told of a culture of in which consultants’ opinions are not valued and very worryingly of concerns raised about patient safety being dismissed as shroud waving.”
Meanwhile the BMA has repeatedly raised concerns since December. At their annual conference in Edinburgh this week chairman Mark Porter singled out NSFT as they only health trust in his speech, stating the “safety and quality of services is under threat”.
Regional consultant chair for the BMA in the east, Dr Rob Harwood added: “If they are going to shrink the frontline and get rid of nearly 500 staff, with a disproportionate 30% of consultants and 40% of other senior doctors that has got to have a serious impact otherwise every other trust in the country would be following suit.
“This whole redesign seems utterly chaotic.
“We have repeatedly raised our concerns but it doesn’t seem to have slowed the trust down at all.
“This redesign is a car crash in slow motion and we would say to the trust, please, please reconsider this unmitigated bad idea.”
Dr Ciara Burgess, a consultant psychiatrist and chair of the Local Negotiating Committee at Norfolk and Suffolk said clinicians are finding it “difficult to understand how 20% efficiency savings becomes a 30% cut to doctors and nurses at the frontline”.
“There has been huge upheaval and disruption because things have changed so quickly, at such a pace with such a vast amount of information, it makes it very hard for already increasingly stretched clinicians to maintain a safe service and keep up and provide meaningful comment on changes and changes to those changes,” Dr Burgess said.
“These changes are already in progress, they have already started and we would contend some changes started before the consultations were over.
“We are concerned that the chief executive is leaving at this time.
“We were conscious that the chair changed relatively recently and the director of nursing who was due to leave this summer has delayed it until November.
“These senior people, who made decisions are going to be gone leaving patients, doctors and nurses to manage a redesign that they, the directors led on.”
Patient safety will be the primary focus – trust respond to claims
Debbie White, Suffolk director of operations for NSFT said: “The trust has been clear from the outset that patient safety will be the primary focus throughout the implementation of the Integrated Delivery Teams (IDTs) in Suffolk.
“While the new IDTs will begin providing the majority of community based services in Suffolk on Monday, a three month transition period, with a robust transition plan has been agreed to.
“This transition plan has been developed by senior clinicians, operational managers and service managers and shared with commissioners to ensure patient safety is maintained throughout.
“The trust is not alone in having to make savings - the economic challenges facing the NHS are well documented.
“Put simply, the trust’s resources will reduce year on year and as a result, the trust has chosen to consult on potential changes to services in a very open way, which we think is the right way to proceed.
“Other trusts are having to make similar changes but maybe doing this in a different way.
“The timetable for the implementation of the Trust Service Strategy (TSS) in Suffolk has already been revised as a result of feedback from the staff consultation.
“The introduction of the IDTs, the new service model and the trust transition plan is supported by our commissioners in Suffolk and the joint Norfolk and Suffolk Health and Overview Scrutiny Committee.
“The trust has been clear since the launch of the collective consultation in October 2012 that all staff across Norfolk and Suffolk are welcome to get involved in developing the strategy.
“In total, 230 clinicians have been involved in developing the TSS plans and the majority of staff are supportive of the proposals and understand the need for change.
“The trust’s nedical director has met individually with all consultants in Suffolk, who are aware of their job roles in the new IDT structure.
“The final staff numbers in Suffolk will not be reduced by anywhere near the 30% that has been quoted. Fewer than 10 clinical staff have been put at risk of redundancy by moving to the IDT structure. “There will also be a reduction of six consultant posts in Suffolk, most of which are vacant.
“The trust has already been clear on the reasons for Aidan Thomas’ resignation. The implementation of the Trust Service Strategy is large and complex and will continue over the next three years and therefore there would have been no ‘right time’ for Aidan to step down.
“Aidan will remain employed by the trust until December 2013 during which time he will be supporting the Trusts commercial projects.”
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