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Commissioning trailblazer warns of hidden deficits as CCG blindsided by £25m shortfall

A GP commissioning trailblazer has warned colleagues across England of the danger of hidden deficits being uncovered within their PCTs, after his CCG was left stunned by the exposure of a £25m black hole in his area.

NHS London has launched an inquiry after deficits of £25.5m were unexpectedly uncovered at NHS Croydon, leaving GPs at risk of being financially crippled when they assume full budgetary control in 2013.

As a result, GP commissioners are being forced to radically reshape QIPP plans to try and tackle the huge shortfall, and fear they could be forced to oversee swingeing cuts unless they can quickly implement radical service changes.

Speaking to Pulse at the National Association of Primary Care conference in Birmingham this week, Dr Agnelo Fernandes, chair of the Croydon Healthcare Consortium, warned hidden debts were likely to be uncovered in other areas too.

Dr Fernandes said there had been ‘disbelief among practices’ when told of the scale of the debts. ‘We were performing well against QIPP but what we now need is transformational change. Otherwise services will have to be cut.’

But he warned: ‘If this can happen to us, it can happen to any CCG. It demonstrates the need for greater sharing of risk.’

The borough’s two pathfinder commissioning groups, Croydon Healthcare Consortium and Commissioning for Croydon, have been compelled to merge into one shadow CCG to tackle the financial burden more robustly.

Board minutes from the NHS South West London cluster reveal NHS Croydon’s accounts for 2010/11 show an ‘adverse variance from the budget of £25.5m’. The report said the only way the trust would now break even this year would be by drawing on ‘£2.29m of the contingency reserve’.

NHS Croydon’s planned surplus of £8.3m for 2010/11 has been reduced to break even. The PCT said it had developed ‘a detailed action plan to get back into balance’, with the help of GPs, while the cluster has asked NHS London to commission independent review of the 2010/11 accounts to see how the discrepancy occurred.

A NHS South West London spokesperson said initial findings suggested the deficit was due to a combination of hospital activity being ‘higher than we budgeted for’, some QIPP and demand management plans ‘not delivering as highly as predicted’, and ‘understated budget setting’.

The spokesperson said: ‘It is our intention to ensure all CCGs in SW London are financially viable when they take over on 1 April 2013.’