Community phlebotomy and community paediatric services are at risk of being reduced or cut, a report by the King’s Fund has found.
The report, which was based on six anonymous surveys with chief executives and chief financial officers at trusts across England, found that leaders said they were now at the point of needing to reduce service provision to patients to save money.
Among the services at risk of being reduced or cut were ‘non-core’ services such as community phlebotomy and community paediatrics, as well as clinical psychiatry to support those with cancer.
Some were also tightening the rationing of NHS services based on clinical need, and others described how they were considering closing or consolidating beds across hospitals, such as stroke or critical care beds.
‘You cut fat, muscle, bone, and I think we’re at the bone point for most services and clinicians,’ said one trust leader.
The report said these cuts would be to ‘maintain patient safety and focus on services that most impact clinical outcomes’.
It added: ‘Some leaders also described how some NHS services are now being delivered by private providers who bid to deliver services at a cheaper rate than the NHS (for example, patient transport services).
‘One leader believed this could leave these services at risk of being cut altogether if the third-party suppliers go bust and NHS providers are not financially able to restart that service.’
The authors concluded that there was a need for ‘realism’ about what can be achieved in the current financial envelope and clarity from the Government about what to prioritise.
‘The scale of the financial pressures ahead means leaders have told us that it is no longer possible for them to avoid taking further action and that they are now left with no choice but to cut staff and services, even if it has a knock-on effect on patients,’ the report said.
NHS Confederation chief executive, Matthew Taylor, said: ‘The findings of this report demonstrate the scale of the financial pressures facing the NHS, due to increased demand and an ageing population. Our members understand the precarious state of the public finances and are doing all they can to boost productivity. However, they are faced with the most challenging financial outlook in years.
‘To help them operate within these constrained budgets while improving productivity, the most important support they need is extra capital funding to unlock productivity improvements and continue to deliver patient care. That is why we hope that next month’s Spending Review will increase NHS capital investment and that the forthcoming National Infrastructure Strategy will open up much needed new routes for mutual investment from the private sector.’
It comes after MPs criticised the Government for a lack of clear plan over the abolition of NHS England, saying it has ‘created high levels of uncertainty for patients and for staff’.
The Government announced plans to scrap NHS England earlier this year, in a bid to ‘reduce duplication’ and to direct more resources ‘back into the front line’.
Earlier this month it was revealed that the ICB running cost envelope was to be reduced to £18.76 per head, after ICBs were told they must make 50% cuts. Bristol, North Somerset and South Gloucestershire ICB has already laid out plans to merge with Gloucestershire ICB as part of efforts to make cuts.
