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STP plans could hit community nurse funding in rural areas, leading nurse warns

RCN deputy president says community nursing will be put at risk unless funding is distributed more evenly.
Community nurse

Community nursing will be put at risk in rural areas unless funding is distributed more evenly, a leading nurse has warned.

RCN deputy president Rod Thomson believes plans to put community care and prevention at the heart of health care, under Sustainability and Transformation Plans (STPs), will fail unless funding stops favouring cities.

STPs represent the biggest shake-up of health services in years, and aim to produce savings by changing the way health care is delivered in 44 areas of England.

The main goal is to transfer the bulk of care away from hospitals, freeing up specialists for acute care.

Rural crisis

Citing an NHS England document that sets out funding allocation for the 44 areas between 2016-17 and 2020-21, Mr Thomson warned that rural areas

Community nursing will be put at risk in rural areas unless funding is distributed more evenly, a leading nurse has warned.


Picture: iStock

RCN deputy president Rod Thomson believes plans to put community care and prevention at the heart of health care, under Sustainability and Transformation Plans (STPs), will fail unless funding stops favouring cities.

STPs represent the biggest shake-up of health services in years, and aim to produce savings by changing the way health care is delivered in 44 areas of England.

The main goal is to transfer the bulk of care away from hospitals, freeing up specialists for acute care.

Rural crisis

Citing an NHS England document that sets out funding allocation for the 44 areas between 2016-17 and 2020-21, Mr Thomson warned that rural areas with less to spend per capita might be unable to afford the required number of nurses to make the transition.

‘If we are to prevent illness and provide more community based care, then it’s essential that funding is switched away from hospitals,’ he said.

‘However, areas where funding is lower will find this difficult, because acute care devours funding.’

Funds are provided through public health grants given to councils for health visitors, school nurses, and sexual health and awareness campaigns. NHS England gives local clinical commissioning groups (CCGs) money to provide medical care.

Equal treatment

Professor Thomson said: ‘If you are looking for a fair benchmark, a starting point is every citizen is equal, and, over the course of life, have the same basic health needs.’

He said the budgets, which factor in expensive city property and pay weightings, failed to account for affluent city areas already achieving the best public health.

He added that rural areas also had to contend with costs, such as travel for community staff to visit patients. 

A Department of Health (DH) report from October 2015 revealed that it took rural-based health visitors five times as long to see clients as their city counterparts.

Professor Thomson added: ‘More staff costs money, so if funds are in short supply, then nursing numbers are likely to be reduced.’

Government response

A DH spokesperson told Nursing Standard that public health grant funding is based on historic spending trends.

A DH circular in December said public health grants would be reduced by an average of 3.9% in real terms, each year, until 2020, in order to achieve savings.

An NHS England spokesperson said: ‘We have adjusted allocations to tackle inequality and improve fairness.’

They added that population growth, rurality, and inequalities in paying for primary care and specialist services, had all been factored in when setting the 2020-21 NHS budgets.


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