LONDON (Reuters), Apr 16 - More than 22,300 NHS posts have been lost in the past 18 months because of cut-backs implemented as a result of the government's insistence on trusts balancing their books, a Royal College of Nursing report said on Sunday.
Most of the cuts have hit specialist services, the report "Our NHS -- Today and Tomorrow" said.
RCN General Secretary Peter Carter said on Sunday that unless the government addressed the situation immediately, the actions taken last year would continue to hit patient care and destabilize the NHS for the foreseeable future.
"Our NHS remains caught up in a rip-tide of cuts, rushed reforms, and poor workforce planning," he said.
"This is hitting services, hurting patients, undermining staff morale, and threatening the hard-won progress made over recent years," he told the RCN annual conference.
Most of the jobs have gone through a combination of compulsory and voluntary redundancies, deleted vacant posts, and recruitment freezes.
Specialist nurses have seen their posts downgraded, while public health and training budgets are being used to plug deficits elsewhere in the system, the RCN said. Qualified nurses have been left struggling to find jobs, it added.
Patients suffering from multiple sclerosis and epilepsy have seen a shortage of specialist nurses, as have those in rehabilitation and intermediate care services, mental health in-patient departments, and day care services.
The RCN said waiting lists and waiting times had suffered, with waits of up to nine months for some diagnostic and specialist services.
Closure programs for community hospitals in rural communities have been extended. Bereavement and end-of-life services for children and families have been reduced.
The report calls for the government to enter talks with frontline staff and give trusts more time and flexibility to achieve financial balance.
It also calls for a move away from a culture of imposing redundancies.
Prime Minister Tony Blair told the BBC that during the next few weeks "we will be putting in place the main building blocks of a reform program" that will lead to a health service which is "stronger, better, more built around the patient."
Last Updated: 2007-04-16 12:41:52 -0400 (Reuters Health)
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
