24.08.16
Top CCG considers prescription & service cuts to plug £8m black hole
Harrogate and Rural District Clinical Commissioning Group (CCG) is considering plans to no longer provide ‘over the counter’ medicines, withdraw services and have a renewed focus on self-care, as it struggles to fill an £8.4m gap in its budget.
The CCG, which last month was rated ‘Outstanding’ by NHS England, said that the rise in demand for health services and increasing costs, outstrips the money available in its fixed budget.
Earlier this year it was announced that the NHS intends to fix the funding for CCGs at the same sum every year until 2021, leading to a decrease in funding per head.
Harrogate and Rural District CCG noted that the number of people attending A&E between April and June this year increased by 2.7% compared to last year, equating to an additional £125,000 cost not planned for. The same comparative period has seen a 14% increase in the number of knee procedures at an additional cost of £160,000.
Plans the CCG is considering to ‘bridge the budget gap’ include no longer providing ‘over the counter’ medicines like paracetamol, which last year cost the NHS locally £260,000 to prescribe. Paracetamol and other painkillers are widely available in supermarkets and at local chemists and cost around 1p per tablet, compared to 3p per tablet on the NHS.
Rick Sweeney, governing body member at the CCG, said the challenge for the CCG is to spend the financial allocation differently.
“As an organisation we have a number of difficult choices to make about what is affordable for the whole of our local population against an ever increasing demand for access to health services,” he said. “We are reviewing all areas of spend including the services we purchase, the medicines prescribed, outpatient appointments and operations.
“Getting medicine on prescription costs much more than buying over the counter due to the time doctors and local pharmacists take when dealing with appointments, handling prescriptions and dispensing medication. Last year, over three million items were prescribed to patients across Harrogate and the rural district at a cost of over £25m.”
Last month, a joint report from the King’s Fund and the Nuffield Trust stated that the clinically led model of commissioning faces barriers because CCGs feel they are not being given the autonomy they need to involve GPs in decisions about commissioning services.
Additionally, an onslaught of measures to heal the troubled financial state of the NHS and improve accountability of trusts and CCGs were announced, just two days after a Health Committee report warned that the health service is not on track to deliver the expected £22bn in savings.
Amanda Bloor, chief officer at the CCG, said that like many neighbouring CCGs across North Yorkshire, “we are facing unprecedented challenges as demand from an ageing and growing population increases”.
She added that the CCG is working to identify as many efficiency savings as it can: “This will mean a renewed focus on self-care and healthy lifestyle choices by individuals and may include reduction or withdrawal of certain services that do not improve outcomes.
“Everyone is aware that public services and specifically the NHS are under significant pressure, and I would encourage local people to help the CCG ensure we can continue to deliver the services needed for local people within the budget we are given from government.”
Earlier this week, Manchester’s three CCGs have all appeared on a list of the five worst in the country for health inequality. New indicators of inequality in avoidable emergency admissions, used as part of the NHS Clinical Commissioning Group Improvement and Assessment Framework, show that Central Manchester CCG had the greatest health inequalities.
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