NHS must ‘strike the right balance’ and take some ‘radical decisions’
07/02/2006
The PCT and NHS Trust Chief Executives in Gloucestershire today issued a joint statement to all staff saying that the NHS locally must make radical decisions and make tough choices if it is to achieve financial stability, maintain the highest standards of patient care and improve the health of the population.
Over the last few years, the NHS in Gloucestershire has consistently performed highly, meeting demanding national and local performance targets for waiting times and access to services. This is reflected in annual ‘Star Ratings’ where NHS organisations in Gloucestershire have received excellent results*.
Despite this, every PCT and NHS Trust in Gloucestershire is currently experiencing significant financial challenges and despite major efforts they are struggling to balance their books. This is in line with the national picture.
On 27th January, 2006, the Department of Health, issued new far-reaching national guidance**. This sets out very clear service priorities and new rules on financial management and changes the way funding is allocated by PCTs (the commissioners or ‘buyers’ of services) to providers (such as Hospital Trusts).
The further implementation of Practice Based Commissioning (supporting GPs and Nursing staff, to have more direct involvement in ‘buying’ the services they feel their patients need), Payment by Results (fixed prices for funding hospital treatment) and Patient Choice makes it even more important that NHS organisations take the necessary steps now to move towards financial surplus and financial stability.
The NHS Trust and PCT Chief Executives in Gloucestershire believe that this will require a significant ‘Community Change’ programme for local health services which is likely to lead to a reduction in services currently provided.
Chief Executive of Cheltenham & Tewkesbury PCT, Caroline Fowles said :
“Despite continuing efforts to improve the way we provide services to patients and despite a 9% growth in local funding for 2006/07, radical changes will be needed if NHS organisations are to ‘live within their means’ and meet national requirements.”
“Although the additional funding for the next financial year is welcome, the majority of this money will be spent meeting the costs of new drugs, improving waiting times and meeting commitments such as the GP contract, consultant contract, pay awards and the Out of Hours service.”
“These are important developments, but we also face some significant challenges if we are to meet tough service targets and priorities for the benefit of our patients within the resources available.”
The NHS in Gloucestershire is committed to meeting these important local and national priorities which include increasing life expectancy and reducing health inequalities by tackling childhood obesity, reducing teenage pregnancy rates and building on the county’s success in meeting smoking cessation targets.
Other important national service priorities that the NHS in Gloucestershire will need to deliver on include meeting challenging targets for ambulance response times, improving access to cancer services, delivering the 18 week maximum wait for both inpatient and outpatient treatment (by 2008), year on year reductions in MRSA cases and improving access to sexual health services.
Chief Executive of Cheltenham & Tewkesbury PCT, Caroline Fowles said :
“It is important for our patients that we remain focused on delivering these improvements in service, but next year we will also have to take the necessary actions to deliver a major savings plan to secure financial balance.”
By 2007/08, the financial allocation per head of population will be approximately 88% of the England average, based on the below average health need of the population in Gloucestershire. However, the demand for healthcare locally does not reflect this.
Chief Executive of Gloucestershire Hospitals NHS Foundation Trust, Paul Lilley said:
“It is challenging for the NHS locally to meet high patient expectations and the rising demand for effective and high quality healthcare within only 88% of average national funding.”
“The underlying difficulty is compounded in 2006/07 by a significant reduction in the prices paid to acute hospitals through the national tariff. The Trust will be paid £21m, almost 7%, less next year than it will receive this year for the same number and case mix of patients. To maintain high standards of care for patients with £21m less will require a leap in productivity coupled with a fundamental re-design of services. Tough decisions will need to be taken.”
PCT and NHS Trust Chief Executives will work together with local authorities, GPs, NHS staff and other local partners to develop a package of proposals to address the current financial shortfall and the efficiency savings for next year, which together totals £31 million.
These proposals are likely to include reviewing the current provision of district general hospital in-patient services across the county with the possibility of providing more services on one site only, reviewing the range of community services provided and reviewing the criteria which must be met to achieve access to services. The NHS in Gloucestershire will also be testing to ensure that all its clinical and non clinical services continue to provide value for money.
Caroline Fowles again:
“No county-wide plans have been drawn up yet for specific service or site changes for the future, but we need everyone including our staff to be aware that change is inevitable and that we will have to introduce change quickly if we are to achieve financial stability and continue to deliver a high standard of care and treatment for our patients. We will be working through the detail during February and early March.”
“Our approach will be guided by the need to ensure we deliver quality services for our patients that are safe, sustainable, offer real value for money and are provided as close to home as possible.”
“We are committed to involving our staff and working with staff side representatives and our local partners to develop our plans and to ensure that the impact on our workforce is minimised as far as possible.”
Today’s statement does not impact on recent consultations and agreed plans for the development of community based services in Cotswold and Vale.
