Health leaders have issued a financial warning as they face a potentially significant financial shortfall in the coming year. The Chief Officer for NHS Mansfield and Ashfield and Newark and Sherwood Clinical Commissioning Groups has announced increasing pressure on local NHS finances and is asking people to use their NHS services wisely.
The organisations that plan health care for their local population based on budgets allocated by NHS England need to save around £20 million this year, roughly twice the CCGs’ normal savings requirement. Increased emergency hospital activity and prescription related costs are part of the reasons for the additional financial pressures facing commissioners.
Dr Amanda Sullivan, the Chief Officer responsible for planning and funding local NHS services, said that the CCGs would need to repay any debts incurred in future years, which would put more pressure on local services.
“It is our role to manage the budgets to deliver health care to our local population. The CCG pays the hospital trusts each time someone attends A&E and we’ve already seen a significant increase in emergency admissions at King’s Mill Hospital in the first two months of the financial year – 576 more admissions than the same period the previous year. Mainly stays of 0-1 days with many discharged with just advice on the same day they attended and who could have been treated by their local GP or pharmacist.
“A&E is for the most gravely ill or for serious accidents that need specialist and immediate emergency treatment; but our A&E department is routinely reporting that patients are presenting with symptoms that could have been treated at home, at their GP practice or with some advice from a pharmacist.
“People are probably not aware of the increased strain this is putting on services and the costs that they are incurring for the NHS for conditions that could be treated differently.
“For example, advice from a pharmacist does not incur a cost for the NHS, a GP appointment costs the NHS, as a whole, around £46 and an A&E visit for the same condition costs around £120. GPs provide a high quality service that is good value for money. They do not receive a payment for each appointment. Hospitals receive much of their income based on the amount of visits or episodes of care that take place.
“These are costs that can be reduced if people change the way they use NHS services. Our message is clear; please do not attend A&E for everyday problems. Use your local GP service or your local pharmacy, and remember the 111 NHS helpline can be accessed 24/7. The out of hours GP service can also be used for urgent care needs that cannot wait until the GP surgery re-opens.
“The CCGs do, however, pay pharmacists each time a prescription is issued. We would urge people to only order what prescriptions they actually need. People who have repeat prescriptions should speak to their GP and request a medications review if their medication is being ordered but not used. In Mansfield and Ashfield and Newark and Sherwood, alone, it is estimated that £1.2 million was wasted over a year on prescribed drugs that were not needed.”
Commissioners say that waste needs to be addressed across the health care system. In the months of March to May 2016 nearly 700 GP appointments were unattended in just one GP practice in Mansfield and Ashfield.
“As commissioners we are expected to plan effective and safe delivery of health care for our local population, today as well as tomorrow; so we have a legal responsibility to do all we can to work within our financial means. We are already taking steps to reduce some costs as commissioners, controlling vacancies and addressing management costs in order to reduce the impact and attempt to recover the CCGs’ position. However, there are likely to be more difficult decisions ahead if we don’t all play our part in relieving pressure on our local NHS services and keeping within our means.”
Peter Robinson, chair of the Mansfield and Ashfield CCG Citizens Reference Panel; the body that represents the patient voice for health commissioners said:
“The position is serious with the CCGs under close scrutiny and expected to recover the situation quickly. The public can respond to these concerns by thinking twice before they waste time of GP practices, nursing and hospital staff time, which is costly. We all have a part to play.”