1. From Media to Influence Unions 21 Conference Tom Sandford Director, RCN England 18 March 2011

2. Background u Legacy of the last government’s response to the economic downturn – £15 – £20B savings from NHS over four-year period; u Raft of new reforms from new government; u Significant chaos in the system; u Public opinion ambivalent towards public employees; u Salary and pensions differentials between public and private sector;

3. u How to secure intelligence in the context of a de-stablised NHS? u How to engage members in the context of fears over significant job losses? u Where is the experience of engaging activists/ members in a different partnership? u Obama/ Blue State Digital.

4. Frontline First Frontline First empowers UK nursing staff to tell the RCN about three key areas affecting health services – Cuts to local health budgets, impacting on jobs and services Waste in the system that squanders critical resources The innovations and new ideas that improve care and save money

5. Cuts The RCN has gathered information from verified sources, including Trust board reports, local press coverage and submissions to the campaign website, exposing the level of cuts made across the NHS. In November, we reported that 27,000 NHS posts have been earmarked to be cut. They include – u Nottingham University Hospitals NHS Trust - needs to save £29million this year and £35million in 2011/2012. The trust plans to reduce 400 posts by 2010/11 u NHS Oxfordshire - Has forecast a reduction in overall workforce numbers by 1,900 WTE over the next 4 years (estimated savings £44.7m). u Sandwell and West Birmingham Hospitals NHS Trust is planning to reduce its workforce by 899 posts by 2016/17 due to the merger of its hospitals. Although a higher proportion of remaining staff will be deployed in the community, the net loss of NHS posts in the area by 2016/17 will be 631 u NHS Tayside - A reduction of 158 WTE nursing and midwifery posts is projected during 2010/11, which is a 3.1% decrease in nursing and midwifery WTE.

6. Waste The RCN has also been collecting information on the vast amounts of waste currently been seen in the health service. We have identified a number of trends, including: Over-ordering on drugs and the throwing away of un-used medication Concerns about administration systems which take up too much time and too many resources Concerns about IT systems that don’t properly support staff The incorrect disposal of clinical waste at great cost Inefficient electricity usage, with lights being left on in unoccupied rooms etc

7. Innovations The third and final strand of the Frontline First campaign relates to innovations – the new ideas that both improve care and save money. u One recent example is the winner of our Frontline First Innovation Award, Marina Lupari. Marina helped to implement a chronic illness case management system which reduced bed days by 59% among the patients receiving its specialist care. Her innovation not only saved £400,000 across the 9 month trial period, it improved her patients’ conditions. u Another example comes from the NHS Wakefield District Community Drug Treatment Team. In Wakefield and surrounding areas a small team of specialist nurses operates both a drop-in clinic and an outreach service to engage with some of the most hard to reach people in society. Whether it’s meeting them in car parks or fast food restaurants, the team ensured that missed appointments were a thing of the past and patients got the service they needed.

8. Innovations The power of specialist nurses Multiple Sclerosis A PCT will have an estimated 10 patients requiring relapse treatment per year and if an MS nurse could treat them at home, this would save £17,970. Epilepsy Epilepsy Action estimates that by reducing waiting times to see a specialist or general neurological consultant, epilepsy specialist nurses save health trusts £80,000 per year. Parkinson’s Disease The Parkinson’s Disease Society report (2006) found that community-based services for people with Parkinson’s could save the NHS an estimated £56 million – or 30 per cent of the money spent on supporting people in care homes – and that Parkinson’s specialist nurse care – as part of a multidisciplinary team – reduces hospital admissions by 50 per cent.

9. tom.sandford@rcn.org.uk 020 7647 3639 www.rcn.org.uk www.frontlinefirst.rcn.org.uk