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CCG facing biggest deficit blames ‘GP variation’ in cost-saving measures

The CCG with the biggest deficit in England has said that ‘GP variation’ in QIPP cost-saving plans is partly to blame for its £29m shortfall, having already clawed back money earned by practices.

Bedfordshire CCG is struggling to get its finances under control after running up the deficit and last month told GP practices it would be using money they had earned through prescribing incentive schemes to help pay off some of the debt.

Board papers from December revealed the CCG now wants to tackle GP variation in QIPP measures, citing this as a ‘major contributer’ to its failure to deliver on its savings targets for the year.

The QIPP programme involves various strategies aimed at delivering the ‘Nicholson challenge’ of making £20bn worth of savings in the NHS between 2011/12 and 2014/2015.  

Minutes from Bedfordshire CCG’s December board meeting discussing the financial recovery plan stated: ‘The level of QIPP savings advised at the beginning of the year have not been delivered – GP variation is a major contributor to this. Reviews have been put in place with localities with relation to reviewing this, however may not deliver much within year.

‘JC advised we must focus on the things we can impact – eg QIPP delivery, locality plans and achieve to the best of our ability. Although we will still have a deficit, we will know we have done the best we can. Also improving quality at the same time.’

Bedfordshire CCG told Pulse the variation had contributed to the £29 million forecast deficit but that practices were continuing to try to improve on QIPP areas such as management of long-term conditions and referrals before the year end.

In a statement, the CCG said: ‘Improving GP variation accounts for less than 14% of our annual savings plan. While we have seen some excellent practice from local GPs in 2014/15, we continue to have levels of variation between our practices that we collectively aspire to improve.

‘This has contributed to our forecast deficit for 2014/15 of £28.8 million, however we know practices are continuing to try to improve on this before the financial year ends. In doing this, our practices are developing consistent mechanisms for improving their management of long-term conditions and support for patients. They are also sharing pathways and audits on clinical practice including referrals.

‘Furthermore we have recently introduced a scheme to improve the quality and consistency of end-of-life care for our patients, which is co-ordinated by GP practices.’

Readers' comments (9)

  • If I was in Bedford, I would have nothing to do with the CCQ and rip up all their policies, stop doing any quip work and stick to patient care to the letter of the contract. Thank god I am not anywhere near them!

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  • Vinci Ho

    Nicholson's challenge is a fallacy and QIPP is one size fits all .
    The only political 'intelligence' here is exploiting the word 'quality' to trade quietly for underlying cost saving.
    GP variation naturally occurs in different practices in different areas with different demography , needs , deprivation and limitations. Only to support and invest back on practices is logical to improve longer term outcomes and hence achieve the real 'saving'.

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  • What are we GPs working in? Is this not just become absurd ? Is it not time to resign from this whole bureaucratic mess of CCGs, QIPPs,QOF, LES, DES, AUDITs etc ? Come on GPC, let us get out and go our own.
    If we are not valued in this NHS and we are not, it is time to leave. Ballot please.

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  • Hey, how much are CCGs paying to the former NHS/PCT staff/Project Managers/'Company Secretaries'/Operations Mangers etc. There was one post that mentioned something of CCG Clinical Officers being in the band of 200k p.a. If that is true, then sure we're cooked.

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  • You are right locality leads 60k in places and educators getting £60k .the managers who got redundancy are stuck ,so recruit retired GPs who have little clue about modern healthcare .kings have seen this in a report.

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  • CCGs are often staffed by GPs who have to spend large amounts of time attempting to improve care and sort finances for their patch. They get paid a sessional rate, usually less than a locum would be paid. Do we value our time so little that we begrudge them? Do others feel they could do the work better? If so stand for election. I far rather see patients and do what I am trained to do. CCGs were imposed upon us but the work has to be done and I personally am very grateful for those GPs who try their best doing a difficult job.

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  • "Do others feel they could do the work better? If so stand for election."

    This is a commonly perpetuated non-sequitur. There are many of us that feel confident that we could do the work better but have no intention or desire to stand. That doesn't make the work any better.

    Conversely, the fact that I can't cook also doesn't mean that I can't tell what tastes good. And some of this stuff tastes like crap.

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  • Odd that noone seems to think that Bedfordshire CCG being almost 10% below "fair shares" has anything much to do with their deficit...

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  • Time for a ballot on exiting this whole sorry mess. That is the only thing that will make the government sit up and pay attention.

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