Diabetics are put at risk as NHS cuts hit specialist nursing posts | Society | The Observer

NHS cost-cutting will lead to more diabetic patients having limbs amputated, losing their sight and suffering worsening health, ministers have been warned.

The number of diabetic specialist nurse (DSN) posts unfilled across the service has doubled within a year. A survey of 385 hospital trusts and primary care trusts (PCTs) by Diabetes UK found that 218 jobs were vacant last year, even though the number of people with diabetes is rising by 150,000 a year.

"At a time when numbers of people with diabetes are increasing, a decrease in the number of diabetes specialist nurses is very concerning," said the charity's chief executive, Barbara Young. "This will mean longer waiting times for specialist support, more unnecessary amputations, more people losing their sight and far poorer health outcomes. This is simply not acceptable."

The research also reveals that the proportion of DSN posts lying unfilled because of cost-saving programmes had risen to 43% – up from 34% in 2009. PCTs and hospitals in England have increasingly been reducing their staff and cutting back on the services they provide as they struggle with the demands of a £20bn NHS efficiency drive, flat budgets and rising costs. The new findings confirm a growing tendency among bosses of cash-strapped NHS organisations not to replace specialist nurses – who also help patients with cancer, multiple sclerosis, Parkinson's disease and other conditions – when they retire, move on or are made redundant. However, these nurses are popular with patients and their families, have a proven record of clinical success and an ability to save the NHS money by helping patients stay at home rather than in hospital.

A recent Royal College of Nursing (RCN) survey of almost 800 specialist nurses found 11% said they were at risk of being made redundant because their employers are having to slash budgets.

The loss of DSNs comes despite the number of diabetics having hit a record of 2.8 million. The disease, which can lead to serious complications such as heart problems or disability, is a huge burden on the NHS.

"Diabetes costs the NHS £9bn a year and that can only increase as a result of these short-sighted and harmful actions," said Young. Diabetics account for 15% of all inpatients.

DSNs work in hospitals or in communities. They play a vital role in helping diabetics manage their condition and remain independent. "DSNs face a severe threat to their workforce in the current NHS climate. There is a clear need for specialist support," added Young.

Ministers signalled their displeasure at cuts which they believe should not be happening. "There is no excuse to cut back on services that patients depend on. It is for local trusts to determine their specific workforce needs, but we have made it clear that any reduction in clinical posts must not have an adverse impact on the quality and safety of patient care. Specialist nurses do a fantastic job and are integral to the future of the NHS," said a spokesman for the Department of Health. But he added that the NHS did need to become more efficient in order to meet the growing demand for healthcare.

"It really is worrying that, despite repeated warnings, NHS trusts are still making short-sighted decisions which risk leaving patients high and dry," said Dr Peter Carter, the RCN's chief executive and general secretary. "Our survey showed that more than one in 10 specialist nurses may already be at risk of redundancy, something which we know would have a serious impact on patient care. Not only does this put patients at risk of needless complications, but by doing so it wastes money. The smart solution for trusts would be to keep investing in specialist services which can keep patients as well as possible and, above all, out of hospital."

One in five of Britain's 1,363 DSNs is due to retire by 2016, the Diabetes UK survey found. Young has written to the health secretary, Andrew Lansley, asking him to take trusts to task if they cut or freeze DSN posts.

via guardian.co.uk