NHS trust urges staff to ration stationery and stamps as cash crisis plumbs new depths

Exclusive: London North West Healthcare Trust warns 'further restrictions' needed to achieve 'planned' £88m deficit

Managers at London North West Healthcare Trust, warn that the trust is 'in danger' of missing its target of a 'planned' £88m deficit and say 'further restrictions upon expenditure' are needed (Rex Features)

One of the country’s biggest NHS trusts has urged staff to ration paper and stationery, to only use second class stamps and has asked heads of nursing put themselves down for ward shifts, as the NHS’s cash crisis plumbs new depths this winter.

In a letter to staff, seen by The Independent, managers at London North West Healthcare Trust, warn that the trust is “in danger” of missing its target of a “planned” £88m deficit and say “further restrictions upon expenditure” are needed.

These include all stationery purchases and computer upgrades having to be approved in weekly meetings with a senior manager, a crackdown on staff using taxis, and a call for furniture to be “recycled” rather than replaced where possible.

Staff at the Trust have warned that spending – especially on agency staff, who were hired in large numbers to help the NHS cope with winter pressures last year – is being cut so abruptly that patient care may suffer and warned of low morale and a “never-ending sense of crisis”.

The letter states that the trust, which manages four hospitals and employs 8,000 people, needs to “rapidly reduce” its spending on costly part-time agency staff, the bill for which has already fallen from £4.9m for August to £3.9m for October.

Heads of nursing, specialist nurses and matrons are asked to “have a day on the ward rosters every two weeks” to help fill gaps left by agency staff the trust can no longer afford.

Labour said the letter, which also reminds staff that “overtime should only be used in exceptional circumstances” showed “how desperate hospital finances have become” after years of under-funding.

The trust is aiming for a deficit of £88.3m this year, agreed with regulators, but may miss even this target, the letter says. Around 95 per cent of acute NHS trusts – those which run hospitals –were in deficit in the second quarter of this financial year and the hospital sector is heading for an overall £2.2bn deficit this year.

Heidi Alexander, Labour’s Shadow Health Secretary, warned that the £3.8bn in extra funding for the NHS next year promised in George Osborne’s Spending Review “is simply going to get lost in the black hole that has emerged in NHS finances”.

“The truth is hospital finances aren't going to be fixed by a clamp down on post-it notes and paper clips,” she said, blaming the financial crisis on cuts to nurse training places, forcing hospitals to hire expensive agency staff.

The NHS budget is set to rise by £8bn between 2015 and 2020, but the health service is also expected to cut its spending by £22bn. Experts predict the next five years will see the longest sustained fall in health spending as a percentage of GDP than at any time in the NHS’s history.

A middle manager at the Trust, who asked not to be named, said that staff had been “knocked for six” by the rationing requests.

“We don't understand how overtime and expenditure on agency staff can be so abruptly cut off before alternative or realistic plans have been put in place to ensure no major fall-out for patients,” they said.

“Permanent staff are expected to take the hit and work longer hours for less. This is not just unsustainable, it is irresponsible and destructive on many levels.”

They said appointments had already been missed as a result of letters being sent second class, branding some of the savings “irrational and counterproductive”.

“It's increasingly obvious that hospitals have no option but to rack up such massive debts if they want to have a hope in hell of providing a half-decent service to their patients. Staff end up working in a continual climate of fear, with widespread insecurity over jobs and a never-ending sense of crisis.”

In October, Addenbrookes Hospital in Cambridge was also reported to have ordered rationing of stationery, ordering staff to stop buying paper – and edict that was eventually relaxed after senior consultants intervened, according to the Morning Star newspaper.

A spokesperson for London North West Healthcare Trust said: “These cost saving measures have been put in place to reduce spending across the Trust, whilst minimising the impact on our frontline services and patient care.”

A Department of Health spokesperson said: "We know finances are challenging, but this government is committed to the NHS and it's values — which is why we're investing £10 billion to fund its own plan for the future.

"The NHS must play its part in delivering efficiencies and we're supporting it with new measures to help hospitals clamp down on expensive staffing agencies and cut spending on management consultants."