Cuts will cripple Royal Lancaster Infirmary warn medics

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The trust which runs the Royal Lancaster Infirmary faces falling back into a state of crisis, according to its own senior medical staff.

A damning new report written by the Medical Staff Local Negotiating Committee (LNC) – and signed off by 17 surgeons, consultants and department leaders – warns that cost-cutting proposals at the University Hospitals of Morecambe Bay NHS Trust (UHMBT) would have serious consequences for patient care.

The report is a response to the trust’s cost improvement programme consultation, which closed on Wednesday.

The trust, which needs to save £30m by 2015, has proposed reducing its staff base by 230 – including 170 nursing, midwife and support staff positions – as well as reducing bed numbers across its four hospitals by 100, 40 of which would be at the RLI.

Other measures include a review of reception functions, reducing spend on energy and estates services, and reduced reliance on bank, temporary and agency staff.

But the LNC report criticises the lack of suggestions to reduce management costs or staffing.

It also notes that £2.5m of external management spending failed to cut costs but instead significantly added to the financial deficit.

Proposals to close a day surgery unit have been described as “perverse”, while plans to remove 30 beds at the RLI could have a “crippling” effect, with more patients left on trolleys, longer ambulance waiting times and surgery cancellations.

The report said: “While we wish to support our management team in making changes that will ensure the long term future of our trust, we cannot support any changes that put patients at risk.”

Key areas of concern laid out in the response include:

*The consultation makes little reference to maintaining (or improving) standards of patient care.

*Commitment to staff and recognition of their value is also a serious omission.

* Proposals to reduce redeployment rights, pay and travel expense protection for staff is questionable, and appears to be preparing the ground for a major reconfiguration project that is yet to come and “once again obscurity rather than transparency is the plan”.

*There is poor accuracy of information and acceptance that IT systems used by the trust contribute to this.

*Much more needs to be done by managers to ensure that clinicians are provided with the adequate time, opportunity, resource and authority to be more involved in decision making.

*There are no plans for managers to provide seven day working, even though clinical and support staff are expected to. The trust has high-bed occupancy rates, and the proposed reduction in beds will have a major impact at the RLI, especially the loss of day surgery wards 5 and 6.

*There has been no recognition that in order for the four main theatres at the RLI to work well, wards 5 and 6 are needed for pre and post operation beds. Many staff question the underlying motives for withdrawing all services at Medical Unit 1, and would prefer a clear open strategy.

*The report said there seems to be a hidden agenda which suggests a “perfunctory” consultation.

Last year, health watchdog the Care Quality Commission (CQC) stopped the trust carrying out elective operating after it was found to have compromised care by prioritising financial control.

The LNC report said: “It is possible some of the current proposals risk reproducing this situation again.”