Cull of the matrons: thousands of senior nursing posts axed

The NHS is experiencing a “dangerous drain of experience and skills” with nearly 4,000 senior nursing posts cut since the Coalition came to power, a new report warns.

Matrons, ward sisters and clinical nurse specialists have borne the brunt of reforms that have disproportionately targeted experienced staff, the Royal College of Nursing (RCN) claims.

The college says its figures – uncovered under Freedom of Information (FoI) laws – reveal a “hidden workforce crisis”. Official statistics indicate there are now 4,500 more nurses on wards than in May 2010 but health groups have long claimed that these mask an under-the-radar haemorrhaging of senior staff.

Matrons and ward sisters are widely considered a vital part of patient care. In his report into the Mid Staffordshire hospital failings, Robert Francis noted that their role was “universally recognised as absolutely critical”.

But the RCN claims the NHS is treating such staff as “disposable”, after its FoI requests to hospital trusts found that 3,993 full-time equivalent (FTE) posts in the most senior roles – categorised as bands seven and eight in NHS jargon – have been lost since April 2010.

It alleges that the NHS is “downbanding” some staff by forcing senior nurses back to lower pay grades or deploying them to more junior roles.

This is leading to a “dangerous loss of experience and skills that are essential to ensuring patient safety and driving up care standards,” the report adds.

The RCN also stressed that the failure to replace these staff with “like-for-like” alternatives could create “significant long-terms challenges” and “result in a loss of experience and talent that cannot be easily reversed”.

Labour’s shadow Health Secretary, Andrew Gwynne, said the disclosures were indicative of coalition that has “wasted billions on a top-down reorganisation of the back office”. He added: “While we know that good ward leadership is important for care quality, it is clear that the Government has not learnt the lessons of the Francis Report. Patients are paying the price for their arrogance.”

Dr Peter Carter, chief executive and general secretary of the RCN, said the loss of specialist clinical skills and experience was worrying. “As more patients require complex care from specialist nurses, letting so many years of skills and experience vanish from the NHS is an utterly reckless policy,” he said.

“We need to be doing everything we can to retain the skills we have in the NHS rather than using them as a quick and easy way to make savings. These cuts are a short-term attempt by trusts to find efficiency savings, yet they will lead to a very serious and very long-term crisis in our health service.”

The Health minister Dan Poulter responded: “The reality is that there are over 4,500 more nurses on the wards than there were in May 2010, and it is for NHS hospitals to decide how many nurses are needed on each ward.

“Thanks to changes being made by the Government, for the first time, we will know how many nurses we need and how many we have, ward by ward. And if hospitals do not have enough, the chief inspector of hospitals will step in and take robust action. This is a big step forward for patients. We know clinical leadership by healthcare professionals matters – that’s why we’re investing £40m in leadership training.”