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Cutting hospital roles will be detrimental to primary care

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Acute cuts will impact primary care Acute cuts will impact primary care staff

Primary care staff will feel the pressure following Monitor's advice to Trust's with financial deficits to only fill 'essential vacancies', says leading nurse figure.

Marina Lupari, the professional officer for primary and community care at the Royal College of Nursing (RCN), said that the ramifications of these recommendations and cuts to the acute sector will push people into primary care or mean that people won't be referred onto further services.'

'The primary and community care setting will not be left unaffected by this,' she stated.

David Bennett, chief executive of Monitor, wrote a letter to the 46 Trusts with the biggest financial deficits with recommendations on how to manage their finances. One of the main recommendations was to cut down on 'non-essential' vacancies. The letter also recommended that Trusts follow guidelines on safe staffing in a 'proportionate and appropriate' way.

Monitor later stated that these recommendations were applicable to non-clinical staff only.

Ms Lupari said: 'If hospitals remove admin staff then who is going to pick up that work? It will be nurses. If you take a ward clerk away from the ward GPs won't be able to get through with phone calls and queries, and this is going to impact on patient care in primary care.'

Ms Lupari also cited the recent cuts to public health budgets as having a detrimental impact on primary care because it will stop preventative work on public health issues. 'On one hand you've got cuts to the acute sector, on the other cuts to local authorities and primary care in the middle which will continue to be squashed. Primary care has already been identified as having serious problems and this is really not going to help.'

She urged politicians to start to look at the NHS as a whole. 'You cannot make changes to one part of the NHS without affecting another.'

Monitor declined to comment on the impact these recommendations might have on primary care.

The letter raised serious concern among other nursing figures. Janet Davies, chief executive and general secretary of the RCN, said: 'Staffing levels are either safe or they are not, and this must be decided based on patient need, using safe staffing guidance. If staffing levels are decided by accountants rather than clinical staff, patient care will suffer.

'It is also unclear what constitutes a non-essential job in an NHS trust. If you get rid of support staff, their work does not disappear. Instead, it will mean frontline staff picking up extra paperwork and spending less time with patients. This is a false economy.'

Royal College of Midwives director of midwifery Louise Silverton, also commented on the recommendation of 'diverting patients' elsewhere. 'David Bennett's' letter also suggests diverting "patients" elsewhere when the reality is that for maternity services it is often the case that neighbouring units don't have the capacity to take on referrals from other Trusts. The government has pledged an extra £8bn of funding for the NHS by 2020. This is clearly money that is needed now, not in five years when it will be much too late. Clearly NHS trusts cannot wait that long for this extra money,' she said.

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