Protect Asthma Nurse Specialists from spending cuts

In the next couple of weeks, NHS organisations will be deciding how much money they will cut from their budgets in 2010/11. Regardless of who wins the general election, expected in May, there will be less money for the NHS to spend. NHS managers are working hard to establish where £15-£20 billion of savings will come from.

There are ways that care can be provided more effectively for less money (delivering Personal Asthma Action Plans is one proven example, as are targeted interventions for patients known to be at risk of poor health). But we need to make sure that the inevitable cuts do not result in the loss of Asthma Nurse Specialists. The Royal College of Nursing, troubled by the experience of previous spending squeezes, has recently called on all parties to recognise the important role that specialist nurses play in keeping people with long-term conditions like asthma well. Asthma UK shares this concern.

Losing specialist nurses might reduce the pay bill, but it will remove what many people see as the lynchpin of their asthma care. Many specialist nurses do much more than what is in their job description. They help join up care and they make sure that extra support is available according to individual need.

That’s why Asthma UK has started to fund Asthma Nurse Specialists in local communities with high emergency admissions for asthma. Typically, they take on a large case book and encourage vital improvements to the way care is organised and delivered locally - bringing benefits to many more patients.

I am pleased that NHS trusts have been agreeing to pay for these posts after Asthma UK funding runs out. They recognise that the business case is compelling, because reducing emergency asthma admissions will save the NHS money. History shows that the loss of Asthma Nurse Specialists, were it to happen on any significant scale, would be a false economy, as more people with asthma would end up with expensive A&E attendances and admissions.

The loss could occur through redundancies or more likely through simply not replacing people when they leave or retire. Instead of reducing these posts, the NHS should make specialist nurses more accessible, for example through greater provision of telephone advice and support. Such redesigns of care can also save money but without harming the quality of care.

2010 will be a challenging year for our public services. If you have ideas for improving care at lower cost, let us know. But also do please tell us if anything happens to your local specialist nurse.

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