Hastings and Rother GPs Lose Budgetary Control
As NHS Care Commissioning Group Is Required To Balance Books

Hastings and Rother Care Commissioning Group (CCG) together with the neighbouring CCG of Eastbourne, Hailsham and Seaford have run up a combined deficit of £37 million over the last financial year. Now each has been formally served by NHS England with ‘legal directions’ under section 14Z21 of the National Health Service Act 2006. 

The Hastings and Rother CCG defines itself as “a GP-led organisation responsible for commissioning the majority of health services for local people”, though neither its Chief Officer Amanda Philpott not its Chief Financial Officer John O’Sullivan are doctors. It spends over £600 million annually on primary care, mainly through GP budgets. It claims that for the previous four years it had “delivered the required financial surpluses” and, along with the East Sussex Hospital Trust, made “significant in-roads into addressing inequalities and improving access, quality and safety for local people”. But if it ever was led by practising GPs, it isn’t now. The effect of the new directions is that, for at least the next 12 months, unless there is a variation of them in the meantime, the centralised NHS Commissioning Board will control its budget and therefore, in effect, direct what medical services are – and are not – going to be made available for patients presenting themselves in its area.

In just six weeks the CCG is required to produce a review of governance, a “capability and capacity review”, i.e. an assessment of what medical services are to be provided, and an ‘action plan’ to implement the recommendations. Both the reviews and the action plan will be subject to the central Board’s approval.

By 2 August the CCG is required to ensure that it is operating within its annual budget in the current financial year, and must then provide “a robust and credible financial recovery plan covering a minimum three year period”. All facts, figures and projections within it are to be subjected to Board scrutiny with “complete analysis of the causes of the current underlying financial position (and) the reasons for the deterioration in the financial position”. In other words, they have to save money and prove how much.

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A “System Improvement Director” has been imposed by the Board to oversee these directions.

The Board’s directions have not arrived unexpectedly. Indeed, in a press release of breathtaking insouciance published on the Hastings and Rother website, the CCG say that they have been expected for a while. “This means”, according to the statement, “that we will get additional support to further develop and implement our financial recovery plan while contributing to achieving financial balance across our local health and care system as a whole”.

What it also means is that the CCG can, and almost certainly will, cut services that are currently being provided or were being projected for future provision, but the blame will now be shared, to a much greater extent, with the central Board: any pressures put on the CCG by front-line GPs can be deflected by reference to the centralised regime.

A brief explanation offered by the CCG for its financial loss refers to improvements in A & E “system performance” and reduction of Delayed Transfer Care cases (where  patients who have been treated in hospital cannot be discharged because there is no appropriate aftercare available) not being “translated quickly enough into reducing either the level of activity or the unit cost”. So there you have it: either the NHS must do less or do it cheaper  –  or both. But either way local professionals, whether GPs or bureacrats, will have little say, if any, on how.

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https://www.hastingsindependentpress.co.uk/wp-content/uploads/2017/05/news.jpghttps://www.hastingsindependentpress.co.uk/wp-content/uploads/2017/05/news.jpgHugh SullivanNewsGP,Hastings and Rother Care Commissioning GroupHastings and Rother GPs Lose Budgetary Control As NHS Care Commissioning Group Is Required To Balance Books Hastings and Rother Care Commissioning Group (CCG) together with the neighbouring CCG of Eastbourne, Hailsham and Seaford have run up a combined deficit of £37 million over the last financial year. Now each...The Hastings & St Leonards non-profit community newspaper