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NHS England overspent by £225m on commissioning this financial year

NHS England has already overspent by £225 million on services it directly commissions for this financial year, papers for its next board meeting have revealed.

The figures, presented in the NHS England performance report to be discussed on Tuesday, also shows that CCGs are on course for an overspend of just £15.6m on all their functions.

Clinical commissioning leaders said NHS England had ‘questions to answer’ about its overspend on the direct commissioning, which includes spending on primary care, specialised commissioning, public health, and secondary and community dental care.

The board paper said one of the ‘key themes’ in the financial year to date was the ‘overspends in specialised commissioning – £225m (or 3.1%) in year to date, and £214m (or 1.6%) in the full year’.

It added that the improvement in the full-year forecast was ‘driven almost entirely by the application of central reserves in the second half of the year. Unaffordable growth in activity remains the key driver’.

NHS Clinical Commissioners president Dr Michael Dixon said CCGs had done ‘remarkably well’ in in their financial management, but that NHS England had ‘questions to answer’ about its performance.

Dr Dixon, a GP in Collumpton, Devon, said: ‘NHS England has been breathing down the necks of CCGs to appraise them, but CCGs have not been able to appraise NHS England. Is it that NHS England commissioners are not being especially careful about what they are commissioning or not checking bills and getting value for money? In some ways CCGs should be holding NHS England to task.’

Dr Dixon added: ‘The fundamental problem is that in our system CCGs pay hospitals according to activity rather than outcomes, so the hospitals don’t necessarily hold back on activities. Some acute trusts have been playing hardball on this, which inflates the amount CCGs have to pay. The overspends are linked to a fundamental flaw in the system, rather than a lack of good financial management by CCGs.’

The NHS England board meeting papers state: ‘In aggregate the CCG financial position is on track, though individual financial health varies significantly. Forty-eight CCGs are forecasting a higher surplus than planned, and 141 CCGs are forecasting to deliver a surplus of 1% or more.’

Readers' comments (5)

  • presumably weekend costs for consultant work will have to be met . Will tis add a further 80m ?

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  • and they HAVE to pay for any GP schemes that create 8-8 7 days a week.

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  • How the hell can anyone have any faith in a group of idiots like this. They demand financial constraints on everything except what they do. Obvioulsy no individual accountability.
    Its clearly do as I say but not as I do.
    Obviouis why the NHS is on its knees and likley to become non vialble sooner rather than later

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  • Mr Hunt : CCGs have 'Accountable Officers' - who will you find accountable for this failure at NHSE? Or are all your words hollow?

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  • This is an entirely predictable situation due to the lack of grip consistently exhibited by NHS England on it's own commissioning role. It has been distracted trying to assure itself of the due diligence of local CCG's instead of doing its own job.
    Who will be held to account for the failure of NHS England?

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