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Prescription cuts contributed to £3bn NHS England ‘efficiency’ savings

NHS England and CCGs managed to find £3 billion of ‘productivity and efficiency improvements’ in the past year despite additional demands on the health service.

A drive to cut ‘low priority prescriptions’ helped reach this goal, with £50 million in savings due to reduced prescriptions. Another £25 million from reducing ‘clinically ineffective or inappropriate and harmful procedures’, contributed to the savings in 2018/19, NHS England said in its annual accounts report.

Significantly fewer CCGs overspent in the past year (33 compared with 75 in 2017/18) despite having to deal with costs outside their control including generic drug price rises and GP pay awards, said the report.

In addition, £600 million of savings was made through changes to how CCGs commission services, the report said.

Reviewing satisfaction with services, NHS England pointed out that more than eight in ten patients rated their GP care as good or very good with extremely high levels of confidence and trust in GPs and other healthcare professionals.

Among the figures included in the report were an extra 9 million GP appointments being made available in the evenings and weekends, a record high of two million patients with suspected cancer tested, and a 2.8% rise in the number of patients undergoing planned treatment.

Yet, at the same time as increased activity, workforce pressures have continued to intensify, NHS England chief executive Simon Stevens said in his introduction to the report.

Greater efforts will be needed in the coming year to increase staff availability and better support the current workforce, he added.

The annual report concluded that while more doctors had been recruited into GP training, attracting GPs from overseas was proving challenging due to uncertainty over Brexit and competition from other countries.

But the expansion in the number of other staff working in primary care, including clinical pharmacists and paramedics, has already beaten the target to recruit 5,000 health professionals in primary care by 2020. 

There had been a ‘key focus’ over the past year on a host of issues related to the performance of Capita – the private firm that runs Primary Care Support England – including including updates to the performers list, administration of GP pensions, movement of records, and timely payments, NHS England said.

And while there had been improvements ‘there is more to achieve in the coming year’, the report concluded.

In a statement published alongside the report, NHS England chair Lord David Prior said the significant year-on-year improvements in NHS productivity against a constrained budget was a ‘remarkable tribute’ to hard-working NHS staff.

‘But the hard work of our staff on its own is not enough. Simply putting more pressure on the existing service risks breaking the system.

‘We have to face the facts: waiting times are going up and pressure on A&E departments is rising. It is too difficult to see a GP and health inequalities are too great.’

He said the NHS has to change fundamentally as had been set out in the NHS long-term plan.

‘To realise these changes, the NHS must have a realistic and well-funded capital investment programme and proper funding for social care and public health,’ he said. 

Dr Richard Vautrey, chair of the BMA’s GP committee, said: ‘NHS England is right to highlight the excellent feedback from patients about their GP services, which is down to the hard work of practices who do their best for their patients.

‘However their work has been made harder because of the failures of Capita’s PCSE service, which was a direct result of NHS England’s cost cutting but simply resulted in GPs and practices picking up the pieces.’

It follows the news that there is still a ‘large’ amount of unallocated GP pension cash sat in an NHS account. Capita runs the NHS Primary Care Support England service, including the processing of GP pension contributions. 

Last week it also emerged that Capita had admitted further cervical screening administration errors