Under-fire health boss insists Norfolk and Suffolk mental health redesign is essential

Aidan Thomas, Chief Executive of the Norfolk and Suffolk mental health trust at Mariner House in Ipswich. Photo: Simon Parker.

Aidan Thomas, Chief Executive of the Norfolk and Suffolk mental health trust at Mariner House in Ipswich. Photo: Simon Parker.

A health boss has warned Norfolk and Suffolk’s mental health trust faces “serious” financial difficulties if it doesn’t overhaul its services, as he faced questions about plans to slash its budget.

But chief executive Aidan Thomas insisted patient safety and quality of care was the priority for Norfolk and Suffolk NHS Foundation Trust (NSFT), despite some senior figures from the Royal College of Nursing claiming its proposals were “incompatible” with maintaining current service levels.

Others said that plans to increase workloads on consultants would hit patient safety, and invoked the failing Mid Staffordshire NHS Foundation Trust as a cautionary example.

Speaking at County Hall in Norwich at a meeting of the Norfolk and Suffolk joint scrutiny committee on the radical redesign of mental health services, which could see up to 500 clinical staff jobs being cut, Mr Thomas said: “If we don’t implement this plan the trust will end up in serious financial difficulties: I can say that categorically. There are no two ways about it.”

Councillors questioned Mr Thomas about the plans, and raised concerns at the lack of fine detail or costings in the proposals, which have already been further updated from the version presented to the committee.

Initial plans anticipated a 33pc reduction in medical staff, including a 31pc cut in consultant psychiatrists, a 50pc cut in staff grade psychiatrists and a 32pc cut in senior nurses by 2016.

Consultant psychiatrists Dr Chris Jones and Dr Marlies Jansen, who wrote letters to be considered by the committee, delivered the most outspoken criticism of the plans.

“The process is clearly not about improving quality – this is clearly about cutting costs,” said Dr Jones, chairman of the Local Negotiating Committee. “This is designing down to meet a budget.

“A one-third reduction means the remaining two thirds of people are going to have an increase in caseload of 50pc.

“There’s no way I or my colleagues can see 50pc more people and continue providing the same level and quality of service. The rest is window dressing.”

Dr Jansen said the plans would result in a doubling of her caseload of 481 patients, and that stretching resources so thinly was “not safe”.

“In cases like Mid Staffs, it’s easy to see someone’s in a soiled bed. The risk for our patients is they are at home, isolated, with no one to see them.”

Mike Kavanagh, Royal College of Nursing officer in Norfolk and Suffolk, said services were of a high standard but safety was no guarantee of quality of delivery.

“To reduce funding over four years is incompatible with maintaining a comprehensive and proactive health service,” he added.

Mr Thomas told councillors that staff had researched cost-saving measures at other trusts and that “almost everything we are proposing is already in place somewhere else in the country”.

He acknowledged there was “a degree of anxiety” among staff, but said he had received as many responses in favour of reform as he had against.

“The staff really care, about the service and about the patients we look after. But even those areas where people are most concerned there’s a general acceptance that the trust has to do something,” he said.

Speaking after the meeting, he added: “Yes, we will see cuts which will affect services.

“But with a planned approach we can control the impact of that and, by remodelling them, we can improve some services.

“If we were to do nothing we would end up with wholesale piece-meal, salami-slicing of the budget.”

Mr Thomas insisted the trust had done its “level best” to inform the public about the proposed measures, adding: “I’m concerned that we keep services safe. That has to be first priority of the trust, and the trust and the board are putting measures in place to do that.”

The next meeting of the committee will take place on March 12 in Ipswich.


  • If the warm words of the CEO are to be believed on safety then why hasn't he ensured the systemic risk assessment of how such cuts are to be made has been published so that the need for public scrutiny is satisfied?What changes need to be made to meet the challenge of increasing numbers of those committing suicide,especially men,revealed recently by the ONS?Are the trust ready for a Judicial Review into its' actions?Will the criminal law be used to call those at the top of the trust to account in the event of their actions going tragically wrong?

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    Peter Watson

    Tuesday, February 12, 2013

  • A DC 2010 election slogan: We'll cut the deficit, not the NHS. Oh well, maybe not, but we're all in it together so it's only right to share some of the cuts with the NHS too. Number one priority is to protect the exec and management structures, not difficult when they are the ones making the decision about where to apply the cuts, and that just leaves the front-line to be "reorganised". I am sure the longer-term objective is to make such a mess of the NHS that govt can put forward a proposal of creeping private sector involvement as a remedy to the very same problems it is creating. I mean come on, mental health services, that's hardly much of a vote winner. If you can't bash the most vulnerable it's a pretty poor do.

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    Mr Cameron Isaliar

    Tuesday, February 12, 2013

  • Yes, interesting isn't it, that most of the supposedly evidence-based elements of this 'radical redesign' end up as 33% cut here, 50% cut there, 40% cut here, 20% cut there, 100% jobs for the bureaucrats here. It is almost as though this has been dreamt up on a piece of A4 paper with nice round numbers. No job descriptions, no service plans, jobs for all the bureaucrats, surely not? If this 'radical redesign' was a research paper, it wouldn't be published. Is the Trust going to remove the gagging clauses from its staff contracts to allow them to speak freely to the press about their patient safety concerns as the Francis Inquiry into Mid Stafford recommends? Is the Trust going to publish the risk assessments and the responses to its 'consultation'?

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    Tuesday, February 12, 2013

  • Commissioners slash budgets, not health services. If the Trust does not have enough money to deliver services either: a) they are under-funded; or b) the money is not being spent wisely; or c) they've racked up an overspend year-on-year and the books now have to be balanced. In our future NHS when we have not only Virgin Healthcare but probably Tesco Healthcare and Sainsburys Healthcare all competing to deliver services, some historical providers will go to the wall. We live in troubled times for the NHS, whatever the politicians might say. From an NHS Manager, not working in East Anglia...

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    Surrey Canary

    Tuesday, February 12, 2013

  • Interesting the difference a bit of journalistic and councillor scrutiny makes, isn't it? 'Radical redesign' becomes cuts. Service improvements becomes 'cuts will affect services'. Clinically-led and not financially-motivated becomes 'If we don’t implement this plan the trust will end up in serious financial difficulties' and designed and supported by doctors and nurses becomes 'as many responses in favour of reform as... against'. Well-researched 'radical redesign' becomes self-serving back-of-a-fag-packet cuts without even job descriptions or service plans. Clinicians were never given the choice of cutting services or bureaucracy. If clinicians were truly empowered, they would cut the paper-pushers and protect services. But the Board wouldn't like that, would they?

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    Tuesday, February 12, 2013

  • There is only one question: How does a 20% productivity improvement under the Nicholson Challenge become cuts of more than 30% in the number of front-line doctors and senior nurses, with bed closures and services slashed, while every single bureaucrat in central corporate services keeps their job? There will be five hundred less staff delivering services to patients but the more than eight hundred penpushers will keep on hugging their clipboards. I haven't met a single doctor or nurse who, in private rather than with a career-gun held to their head, believes these changes will work or are safe.

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    Tuesday, February 12, 2013

  • Its nothing to worry about. Its all part of the endemic culture of self-interest, secrecy and spin infesting the NHS like a chronic illness. See front page of EDP today. MPs and their CQC puppets talking tough about the woeful EEAST, but it will all come to nought because at the end of the day they are playing out an elaborate farce for public consumption whilst preserving their intertwined interests behind the scenes.

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    Police Commissioner ???

    Tuesday, February 12, 2013

The views expressed in the above comments do not necessarily reflect the views of this site


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