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10.13 Overseeing a CCG budget of more than £400m

Just back from a week’s holiday in Paris to celebrate my wife’s retirement as a full-time GP in a very busy general practice in Stockton. She made it to 60, but unless we find a way to reduce the pressure on GPs in the near future we will see many retire even younger.

I am currently the Chief Clinical Officer for the Durham Dales, Easington and Sedgefield CCG (DDES). I spent all day yesterday in surgery, so today is my first chance to catch up on the 2014/15 contracting round. As the accountable officer for the CCG, I am responsible for a budget of over £400m. Most of that is spent on our acute and mental health hospitals and we are keen to create a stable financial environment for our local hospitals and for our CCG. Last year we did this by negotiating a block contract but are currently able to afford £11m less than our major provider wants to secure a block contract for this year.

The emphasis now is on providing more services in the community and in primary care, but we need to hold down costs in secondary care so that we can invest in more cost-effective primary care services. This year we intend to begin that process by increasing our investment in enhanced services and by encouraging and pump-priming the development of federated practices across the CCG. In this way GPs can begin to provide more services, at scale, in the community.

If we can work with our local area teams and get this right, we stand a chance of making primary care more interesting and allowing GPs to develop their practices. GPs have more control over how the NHS budget is allocated than ever before and we need to use this opportunity to deliver more care closer to patients and to develop primary care. This may be the best opportunity we will have in a long time to make primary care more interesting, increase investment, entice more doctors to come in to general practice – and perhaps even encourage a few less experienced GPs not to retire early.