RCN chief executive and general secretary Dr Peter Carter told delegates at the RCN Congress the savings and efficiencies the NHS has to make over the next few years will result in inevitable changes in the way key services are delivered.

He said: ‘It's never popular to talk about closing local services or moving healthcare teams from one location to another, but it's always important to ask the objective question: "Will this change bring about an improvement to patient care?"

‘If the answer to that question is "yes", we have to consider changes, be open-minded about new services and embrace new ways of working.'

Dr Carter also called for realism about future pay awards, but promised to fight any attempts to undermine national pay awards.

‘Our priority has to be the preservation of front-line clinical services. It would be pointless having a pay award at the expense of services and jobs,' he said.

But he said the news some NHS managers received pay increases double that of nursing staff, as outlined in a report by financial analysts Incomes Data Services earlier this month, demonstrated ‘very poor leadership'.

He also called for the DoH-commissioned McKinsey report, which was leaked last year and outlined a number of huge savings the NHS could make, to be released in full.  

‘For one reason or another, this report was quickly buried and no one wanted to talk about what it suggested. My challenge to decision makers is this: let's see it, let's read it and let's see what it has to say.'

Meanwhile, Mr Carter announced plans to launch a ‘Frontline First' campaign, which aims to highlight where nurses are making innovations, where they are saving money and where money is being wasted.

He said: ‘We will expose where the cuts are being made, where patient care is suffering and where efficiencies could and should be made.'

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