CCGs will be asked to make further savings of £30bn in addition to the £20bn QIPP savings they are already having to make, NHS England has announced.
In a much-anticipated document, launched today under the banner ‘A Call to Action’, NHS England calls on CCGs to formulate 3-5 year plans to help solve a funding gap of £30bn by 2020/21.
The document says the funding gap must be solved through ‘freeing up NHS services and staff from old style practices and buildings’. The consultation process will focus on producing ‘meaningful views, data and information’ that will help CCGs implement already-announced policies such as shared patient records across services, telehealth, early dementia diagnosis and better management of long-term health conditions.
GP leaders have cast doubt on whether the savings can be made through these methods, however.
CCGs will be required to meet with charities and patient groups to find ‘local solutions’ to the challenges facing the NHS from issues such as a UK budget freeze, an ageing population and the rise of obesity and people living with longterm health conditions.
The document said: ‘[A Call to Action] will produce meaningful views, data and information that CCGs can use to develop 3-5 year commissioning plans setting out their commitments to patients and how services will improve.’
NHS England chief executive Sir David Nicholson said the ongoing ‘Nicholson challenge’ to cut £20bn in NHS spending in efficiency terms by 2015, mainly achieved to date through staff pay freezes and pension reforms, was not enough.
He said: ‘Our analysis shows that if we continue with the current model of care and expected funding levels, we could have a funding gap of £30bn between 2013/14 and 2020/21,which will continue to grow and grow quickly if action isn’t taken. This is on top of the £20bn of efficiency savings already being met. This gap cannot be solved from the public purse but by freeing up NHS services and staff from old style practices and buildings.’
News of a strategy consultation and public engagement process has been floated since the reforms under the Health and Social Care Act came into force in April, when NHS England’s head of primary care Dr David Geddes as well as its chair Professor Malcolm Grant both referred to plans in exclusive interviews with Pulse.
Dr Chand Nagpaul, a GPC negotiator, said that it was important that NHS England was being honest with the public.
However, he added: ‘That has to be matched by a Government also committed not to use NHS money for populist measures. I think there is an incongruity in this statement and Government actions. Because at the same time we are being told that policies of public convenience will be put in place. An NHS that needs to save another £30bn cannot afford seven-day opening times in general practice, nor is remote registration and choice of GP. And email consultations will actually increase, rather than decrease, GP workload.’
Dr Mike Dixon, chair of the NHS Alliance, welcomed the document. He added: ‘This is a new direction which we have really not seen before. It is interesting that NHS England is talking directly to the population, something that the Department of Health never really did. That is a new thing in itself.
‘We need to do all of these things, moving care into the community and so on. I think with this and the other discussions going on currently, including regarding out of hours and GPs becoming named clinicians, changes to QOF, we will see very interesting GP contract negotiations this year. There are a lot of things in the air. I think these things will have an enormous impact on the GP contract.’
Sir David has been criticised for not informing MPs of plans to hold the engagement process. Last week, while giving evidence to the House of Commons health committee, Sir David was forced to admit that £3m of taxpayers’ money has been put aside to produce ‘materials’ for the process before MPs were told, but still remained coy with the committee about exactly what it would entail.
Announcing the news today, he said we must make ‘bold, clinically-led changes to how NHS services are delivered over the next couple of years’.
He added: ‘We are facing demands, opportunities and investment unimaginable when the NHS was created in 1948. New data is available now to highlight where we get it right – and as importantly, where we get it wrong. We are setting all this out today – including the funding gap – to encourage the public and doctors and politicians to have an honest and realistic debate about how they want their local NHS to be shaped. With the new independence of NHS England and the establishment of GP-led commissioners, we can find local answers to meet these challenges.’