CCGs must consider the impact of their decisions on the health economy to rectify an ‘unsustainable’ financial position, the Government spending watchdog has said.
The National Audit Office (NAO), which scrutinises public spending on behalf of Parliament, said the situation which saw 19 CCGs ending 2013/14 in deficit had led to planned projects being delayed during the year and plans for 2015/16 not yet stable.
While the laregest impact on the worsened financial position was ‘largely due to growing financial stress in the NHS trusts and foundation trusts’, the NAO recommeded NHS England put pressure on CCGs to reconsider their spending.
The report said: ‘NHS England expects CCGs to achieve a surplus, but 19 of them did not do so…These trends are not sustainable. An increasing number of providers and commissioners are in financial difficulty. Some NHS bodies have not made large enough cost savings, or contained the increasing demand for services within their available funding, whilst meeting quality and access targets.’
It added: ‘NHS England should reinforce to clinical commissioning groups the requirement that they set out in planning documents how they have considered the impact of their decisions on other parts of the local health economy. There are examples of clinical commissioning groups starting to do this. But the Committee of Public Accounts has previously raised concerns whether devolved commissioning decisions would take a sufficiently strategic and joined-up approach to meet patient needs.
‘NHS England should promote best practice. It should also be prepared to challenge more robustly commissioners’ plans that do not clearly consider the impact on the wider health economy and explain how competing demands for limited resources from different providers and commissioners will be resolved.’
However shadow health secretary Andy Burnham blamed the Government’s NHS reforms for the dire financial state of services and said that what the NHS needed now was more investment – which Labour leader Ed Miliband promised at the Labour Party Conference in September.
He said: ‘This report delivers a devastating verdict on the NHS re-organisation [Prime Minister] David Cameron said would not happen. It has brought the NHS to the brink of bankruptcy by wasting £3bn. Across England, the NHS is running out of money and patient care is heading backwards. It is clear ministers have lost control of NHS finances, with a massive deterioration in the last year.
‘The NHS is heading for the rocks. It proves David Cameron cannot be trusted with it. He must produce an urgent plan to show how he’ll turn the NHS around. Labour will rescue the NHS with our £2.5bn Time to Care package which will fund new staff including 20,000 more nurses – investment the Tories will not match.’
A recent Pulse investigation revealed that CCG financial difficulties had impacted on their ability to invest the promised £5 per patient on supporting elderly patients in general practice this year. This included one CCG admitting it had spent the funding on propping up its urgent care budget.