NHS England has decided that the full amount of the Chancellor of the Exchequer’s Autumn Statement boost to NHS funding for 2015-2016 will go directly to the Clinical Commissioning Groups. The total sum for this part of the extra money for the NHS is now put at £1.1 billion.
About half this money will go to just a quarter of England’s CCGs. Wiltshire CCG will get an extra £13,916,000. That equates to a 2.75 per cent rise on top of the sum the CCG was already expected to receive for the next financial year.
This makes a total rise in Wiltshire CCG’s funding for 2015-2016 over the current year of 4.45 per cent. So we are back to the sort of year on year increases given by the last Labour government.
This comes after four years of minimal increases of about 0.1 per cent – just enough to keep in line with the government’s pledge to give the NHS annual ‘real term’ increases. One senior NHS manager Marlborough News Online spoke to (not at the CCG) said she would have described next year’s increased funding as ‘better late than never’, but now the NHS was in some degree of crisis it was simply ‘too late’.
Wilthsire CCG has done well. Before the announcement, Wiltshire CCG was looking at a £20million gap in its funding for 2015-2016. The CCG’s Simon Truelove told Marlborough News Online he was “a very happy finance director” when he heard about the level of extra funding: “We very much welcome the allocation we have received. It has made it much more achievable to bridge the gap. There’s still a £11-12million gap – and that’s a huge challenge.”
It is not thought very surprising that the government should channel this money to the commissioning organisations that they set up as part of the major Lansley reorganisation. But the timing is somewhat unfortunate when the NHS crisis has been focused on hospitals.
This extra money for the CCGs is not quite all it seems: it rolls up some other one off payments NHS England makes including money to meet new statutory targets in mental health and the ‘resilience money’ – otherwise known as the ‘winter pressures money’. Simon Truelove says this is better than handing money out just before winter begins: “We can now plan for next winter and get the staff in and so on.”
Many hospitals received no money at all out of last year’s £700million winter pressure payments. And it is hospitals too that are going to be targeted for savings – i.e. less income – under the government’s Better Care Fund.
Money spent trying to keep people out of hospitals takes time to show results and the ageing population may catch up and overtake such measures. It is important to remember that the Better Care Fund is solely concerned with the ‘frail elderly’ and not with the young people who cannot get doctors appointments when they need them and so go in increasing numbers to A&E instead.
At the time of the Autumn Statement, Marlborough News Online asked: “What will George Osborne’s £2billion NHS boost mean for Wiltshire – will it fill next year’s budget gaps?”
To put the increase in Wiltshire CCG’s funding into context, the extra £13.9million will certainly pay for the £9,183,000 the CCG will be paying Wiltshire Council to protect social care work that has been hit by central government’s funding cuts.
As the Better Care Fund will be largely funded by the CCG and will concentrate on social and community care, it might be argued that the government has simply found a neat backdoor way to make up for its swingeing cuts to local authorities.
Simon Truelove remains very positive: “For us it’s a really, really good outcome.” But the impact of the cuts on local councils worries him: “I am still concerned about the funding position of local authorities – given they are facing further cuts and they are instrumental in the health and social care system.”
One of the many causes of the current A&E crisis is ‘delayed transfer of care’ – which some newspapers still insist on calling ‘bedblocking’ as if the patients were purposefully not leaving their hospital beds at the end of their treatment. (Other candidate causes include the troubled NHS 111 service, GP’s, out of hours services and simply the ageing population.)
Simon Truelove’s concern is that without properly supported social services, good patient flows in and out of hospital – especially as regards the elderly – cannot be maintained. And then the crisis may continue.
A state of ‘permanent crisis’ to add to the NHS’ state of ‘permanent reorganisation’ or ‘permanent political interference’, will not help patients or staff.
For the record Swindon CCG is receiving an extra £7,642,000 for 2015-2016 – that’s a total increase of 6.4 per cent on the current year’s funding and three per cent more than it was expecting.
The Swindon South constituency is a Conservative held marginal and Swindon North is sometimes described as a Conservative held semi-marginal constituency.
Many CCGs and constituencies overlap. But the Health Service Journal has published research that shows that the constituencies covered by the CCGs that have gained most – that is between 3 and 4 per cent rises on top of their expected funding – nearly 85 per cent are held by the coalition parties.