The Wiltshire Clinical Commissioning Group (CCG) has written to all the county’s GPs telling them about its ‘very serious financial position’. The GPs are addressed as ‘members of Wiltshire CCG’ and the letter is signed by Deborah Fielding (the CCG’s Accountable Officer) and Dr Peter Jenkins (the CCG’s Chairman.)
The letter has been seen by Marlborough News Online.
The CCG has been called in by NHS England as its forecasts show that at the end of the financial year it will be short of its financial target by £4.8 million. More alarmingly, the letter tells GPs that “on current planning assumptions [the CCG] will have a funding gap of approximately £23 million in 2016/17”.
The CCG’s budget for 2015/16 is about £530 million.
NHS England has ‘requested’ a Financial Recovery Plan. And the letter warns that in two months time, if there is not sufficient evidence that actions are being carried out to improve the financial position sufficiently, the CCG will be put into “turnaround’ status by NHS England. This will include “external intervention into our local health service in order to recover the financial position”.
The main reasons for the current overspend are cited as an increase in the number of planned operations and the increased spend by GPs on prescriptions. “Very simply”, the letter continues, “NHS Wiltshire CCG cannot continue to fund the excess demand that is being experienced.”
The CCG are taking a number of steps to limit their spending:
• they have capped the amount of planned care they buy from hospitals – that is those operations that are not emergencies.
• they are considering ‘pre-referral’ clinics to make sure a ‘patient really needs acute care intervention’.
• they are seeking rebates from drug suppliers.
• they are negotiating how NHS targets can be met within the contracts they have with hospitals.
• they will be enforcing ‘contractual terms more stringently’.
And they ask for the GPs support.
The CCG are also considering further controls to makes sure that hospital clinicians check back with GPs before deciding on clinical intervention. They are reviewing the repeat prescription process. And they are reviewing the use of branded generic drugs. More ‘specific details’ of the action the CCG is going to take ‘will follow very shortly’.
Putting more pressure on the acute hospitals which serve the people of Wiltshire, will almost certainly make their financial positions worse. GWH is expecting a deficit this year of between £12 million and £14 million and across England the hospital sector is expected to have a deficit totalling £2 billion by the end of the year.
The CCG’s letter states: “Failure to respond to these intentions will result in difficult and prolonged financial decision and contractual negotiations for 2016/17 as well as threatening the sustainability of existing services.”
The letter makes no mention at all of the government’s Better Care Fund scheme under which millions of pounds of the CCG’s budget have in effect been passed over to Wiltshire Council. Indeed the letter does not mention the Council at all – and the Council is always very keen to tell people how much it is involved in decisions about Wiltshire’s health services.
