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CCG instates minimum 12-week referral waiting times

GPs in one area will have to tell patients they need to wait at least 12 weeks for non-urgent treatment in secondary care going forward.

NHS Cambridgeshire and Peterborough CCG is currently bringing in minimum referral waiting times to help plug deficits.

The area is one of 14 struggling health economies singled out for the Capped Expenditure Process (CEP) – a regulatory intervention brought in by NHS England and NHS Improvement to cut spending in places with the largest budget deficits.

Th minimum waiting time will apply for all adults requiring non-urgent treatment, whilst children will be exempt from the rationing procedure.

The CCG stressed that patients would still be seen within the 18-week target set out in the NHS Constitution.

Jonathan Dunk, the acting chief officer at Cambridgeshire and Peterborough CCG, said: ‘As part of cost management for the local health system we are proposing that 12-18 weeks would be the expected waiting time for adult non-urgent cases.’

He added that ‘any urgent treatments such as emergency life, limb, sight or hearing treatment, or cancer diagnoses and treatment’ would not be subject to the minimum waiting time.

The CCG, which agreed the policy at a meeting with NHS England and NHS Improvement in May, has already decided that it will freeze access to free fertility treatment, unless there are exceptional circumstances, in a bid to save costs.

Other rationing measures agreed at the meeting included replacing direct oral anticoagulants (DOACs) with warfarin; encouraging GPs and hospital doctors to reduce out-patient appointments ‘where this is of low clinical value’; as well as introducing over-the-counter prescribing restrictions.

According to board papers, proposals that were not agreed at the meeting had also included restrictions on patient choice ‘in order to repatriate work from the independent sector’; and delaying the implementation of NICE recommendations on the use of new and existing medicines and treatments.

Mr Dunk said that the CEP had given the CCG the ‘opportunity’ and ‘support’ it needed to ‘discuss the measures required’ to agree an ‘affordable’ plan for 2017/18.

He said: ‘The proposed measures resulting from this process will enable our health economy to achieve the best possible clinical outcomes for the public we serve, whilst ensuring expenditure remains within funding levels available to the NHS in our area.’

Under the CEP, which was launched in April this year, 14 struggling health economies were presented with a cap on spending and a range of savings ideas.

In the case of Cambridgeshire and Peterborough, the area’s plan was £9.7m above the financial control total for the area, made up of CCG and NHS trust budgets and the area’s sustainability and transformation fund allocation.