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