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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.’