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CCG faces deficit of £29m

The CCG with the ‘worst deficit rise in the country’ is now facing a budget black hole of almost £30m, having been told it needed to create a £4.6m surplus at the start of the year.

At a governing body meeting in December, NHS Bedfordshire CCG chief clinical and accountable officer Dr Paul Hassan warned that the situation was ‘worst in the country’ as it was looking at a £25m deficit, but since then the costs have spiralled and in only a few weeks that number has been reassessed as £28.8 million.

The news is the latest in a string of warnings over CCG finances, with NHS England expecting a swathe of CCGs to end the year in the red.

NHS Bedfordshire CCG had been told by NHS England at the beginning of the financial year that it needed to create a £4.6m surplus in 2014/15 but instead the deficit has sky-rocketed. Locally, poor financial forecasting and higher than expected demand in secondary care were blamed for the troubles.

A spokesperson for the CCG said: ‘At our last governing body meeting we announced that we expected to end this financial year with an overspend of around £25m. We have continued to work with NHS England to assess all possible expenditure for this financial year. Having completed this work, we are forecasting a deficit of £28.8m for this financial year ending March 2015.

‘We are continuing to work with our provider hospitals, neighbouring CCGs and our GP members to ensure we do not exceed this sum while maintaining our focus on the quality and safety of the care we offer.’

Dr Hassan said: ‘Much of our overspend has been on caring for patients at our local acute hospitals, but we have also seen a large rise in costs for providing mental healthcare and continuing healthcare for people in the community. In addition, our savings plan for this financial year is not delivering as much as expected. It is imperative that we control our financial position as soon as possible if we are to provide safe, high quality, affordable care for local people.

‘We have appointed a turnaround director and are working with NHS England, local healthcare providers and neighbouring CCGs to minimise our costs this year and next. At the same time, we are developing a longer-term recovery plan that takes account of the rising and changing demand for healthcare in Bedfordshire as outlined in the current strategic healthcare review.

‘Financial recovery will inevitably involve taking some difficult decisions about local services. We will be working differently as commissioners and are reviewing all our contracting processes and governance structures to ensure we have the capacity and capability to deliver our recovery plan.

‘We will continue to use the best practice engagement that we have developed over the past 18 months to involve local clinicians, patients and partners in our plans and ensure we retain our focus on the quality and safety of care for our patients.’

NHS England has already said that 18 CCGs are expected to end the financial year in deficit.

Readers' comments (14)

  • The Bedforshire CCG:
    there is no way it will go in surplus:
    1. ancient mental health service: previously the building in which the MH pts are kept is so poor and at times its in basement. Crisis team discharges patients who are suicidal back into community.
    2. waiting times for most services in secondary care has rocketed: waiting times to dermatology, rheumatology, for hip replacement, knee replacement is very poor.
    3. the CCG is made up are making up as they go. When they try to do something useful the secondary care causes restrictions which doesnt allow any change to happen.
    4. waiting time in A&E is high. demand in A&E is high. Population of Bedford is balloonin but the BCCG came up with a plan to close the A&E! its only after marches arrnged by local residents there was a U turn.
    5. In the name of ' better care for patients ' the only vision is how to save money at any cost.
    6. alot of my hospital colleagues fear for their jobs: many consultants avoid joining Bedford Hospital as future is uncertain.
    7. the BCCG was set to fail: despite what my politically influenced GPs says since the start of Bedfordsire CCG we knew it will fail to deliver the savings asked for.
    8. Primary care are already under intense pressures, most of my colleagues have extra clinics, extra apointments in end of morning and afternoon clinics to meet the demand. the extra work isnt funded.
    9. OOH is so stretched that at weekends one doctor who is visiting may have 8-12 patients and hence waiting times of 3-4hrs. OOH unlike the way it was 5 yrs ago is so busy that shifts used to go unbooked and they resorted to advertising OOH as a salaried job (selling point: no paper work, no hospital letters to go through, no pathology results to see). I am not sure if anyone has taken this but this isnt what GPs are suppose to be doing.
    10. musculoskeletal services and community dermatology services are privatised.
    11. the PCT employees are all working at CCG in different roles. the disolution of PCTs and creatio of CCGs was huge waste of money. the politicians : conservatives and lib-dem are responsible for this. NOT the local GPs.
    12. We need to find a way to take Andrew Lansley and J Hunt to court for significant wastage of public resources without ANY evidence to justify creation of CCGs. the dismantling of PCTs had started while the consultation was going on!
    13. Currently services are being dismantled without any thoughts given to 'patient care' its all to do with balancing the books.
    14. I am glad I refused to take any acive role in the Bedfordshire CCG 2years ago as my gut instincts where we were being setted up to fail and deliver the impossible.
    15. Those GPs in BCCG needs to be honest and 'reflect' on what has happened in last 2 years and say the truth. the above explanation from Paul Hassan isn't adequate. How can he suggest savings can be made when the mental health service, Bedford hospital and primary care needs more investment to bring them up to standards rather than find more 'savings' from this areas.

    Like other articles in Pulse the truth is NHS lacks significant investments, demands are very high and unless someone has the courage to discuss some sort of payments from patients NHS isnt going to survive and die slow painful death over years and will put patients at risk (if its not already happening!!!)

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  • burying the news prior to christmas!

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  • @3.17pm

    Your story sounds very familiar. It's happening in most places across the country.

    If the government can't put more finances into healthcare, the only way is to ask for money directly from patients. Quite frankly the NHS is now unsafe due to a lack of resources

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  • So with full delegation of commissioning I wonder which budget will be raided to balance the books?

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  • Bedfordshire for years has always been underfunded.

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  • Come on chaps, it's time to fall on your swords.

    At least do that well.

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  • I note a doctor is the spokesperson for the overspent CCG. This is exactly what the politicians want. No way should any clinician be dragged down by these fiascos.
    The underfunding of the NHS is a political matter and must be solved politically. On Sunday the Archbishop of York was brave enough to suggest that we should all be prepared to pay a bit more for the NHS. How about a hypothecated 10p a litre temporary petrol tax??

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  • The public finances committee recently criticised NHS England for underfunding places like Bedfordshire to the tune of 10% and then requesting further reductions. I think the term level playing field was used. If they gave Bedfordshire the same budget they give other CCGs, it would not be in the red. It IS all political, and the NHS theater is really going to kick off in an election year. GPs have delivered huge reductions year on year, but they reduce the budget even faster. They created this internal market, and fragmentation of care through privatisation and compulsory tendering and an AQP menu of services, but can't fund it. The latest fad, import health care models from America. Have they not seen the film Sicko?

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  • why is Bedford CCG trying to balance the books rather then putting pressure on NHSE and goverment to fund the CCG appropriately.

    seems like Bedfordshire will have to wait to have poor outcomes in many areas before anyone starts listening

    have a mid-staffordshire like crisis first! is that what NHSE is waiting for?

    I have seen the AAU stretched to the limits, medical referred pts are kept waiting in A&E for 4-6 hrs as there are no beds in AAU.

    keep on getting emails from BCCG stating Bedford hosp is full please do not refer unless absolutely necessary! as if I like referring pts: I refer when clinically appropriate.
    the risk to GPs has increased
    pts visits the GP multiple times despite being referred : as they cannot get appt soon enough and are struggling with their symptoms. at times I have begged the appointments office to help out: they then say please write an urgent letter!

    the funding has not increased in proportion to population expansion. (not blaming any immigrants)

    BCCG needs to give us the funding level in last 10yrs and comparison to the population it serves and give us £/pt/year funding in Bedfordshire and compare it with other CCGs.
    I think the current funding is based on >10yrs ago population.

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  • The difficulties are partly that NHS comissioning historically " rewards failure"- when money was plentiful additional cash handouts went to those who fail.
    We have a similar position in an adjacent CCG where a poorly structured and run secondary care service is a continual bleed on the finances.
    There is no incentive to be "lean" when the more you do the more you earn and poor performance earns an additinal cash bailout.
    This of course only works for large units like secondary care," fail" as a GP practice and the system is happy to let you close.
    "too big to faill" - the route of the financial crisis and now mirrored across 100's of foundation trust secondary care proviodrs in the NHS.
    Hospitals do have to bear the risk of population changes between national census- and we all know that "the poll tax" meant the NHS dealt with a lot of people who " did not exist" in terms of payments.
    So much so that one local area had all its GP's investigated for fraud in the late 1990's reason two hundred thousand registered patients vs the seventy thousand on a census return- and it went quiet when 99.1 % of GP registrations had a unique body attaqched to it in the audit.
    If there has been a large scale migration to this area from abroad you can bet the same "more physical bodies than the statistics permit" applies.
    Bring back the universal NHS registration card to be produced to show entitlement to free services

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