The Royal College of Nursing (RCN)'s claim that the NHS is "heading for crisis point" as job losses grow has been challenged by the NHS Confederation.

The RCN has reported that 56,058 NHS positions are now being axed across the UK, with 48,029 posts in England alone set to be cut or having already been lost since the College began tracking post losses in April 2010.

An analysis of 41 trusts in England has found that clinical posts make up 49% of the total workforce cuts, with nursing posts (registered nurses and healthcare assistants) accounting for 34% of the positions earmarked to be cut. On average, across the 41 trusts, 8.3% of qualified nursing jobs will be lost, with "potentially disastrous consequences for patient care," says  the College.

“There is clear evidence that the quality of care and patient safety is improved when you have the right numbers and skills in place on wards," said the RCN's chief executive, Dr Peter Carter.

"Staffing levels should be based on rigorous clinical evidence and should not be arbitrarily lowered in a short-sighted effort to save money," and the College is currently working with members of the House of Lords to table amendments to the Health and Social Care Bill "to ensure mandatory safe staffing levels," he said.

However, according to the NHS Confederation, the RCN report has simply counted the number of job losses and automatically assumed that any job going is bad for patients.

"That is just not the case," said the Confederation's deputy chief executive, David Stout. "We know that in many cases, better care can be provided in the community and by concentrating some services in specialist centres. If we can shut spare capacity and release the savings, the NHS stands a chance of staying in financial balance and protecting services." 

Mr Stout pointed out that overall NHS clinical staff numbers will remain at about the same level as they are now, but that services will have to be offered in different places and by staff with different sets of skills. “Given that about 70% of the NHS budget is spent on people, it is unrealistic to expect staff to be unaffected," he added.

"There is going to be a lot of change and all of us - from policymakers down to individual staff members - need to make sure this change is in the best interest of patients," said Mr Stout.