The NHS has to reduce its costs to balance its budget, with a national shortfall of £30 billion over the next 5 years.
In Wolverhampton, this means the city's Clinical Commissioning Group (CCG) - which is led by local doctors, nurses and lay members and funds healthcare services for about 250,000 people - needs to reduce its spend by £37 million over the next 5 financial years.
Dr Dan de Rosa, Chair of Wolverhampton CCG and a GP in the city, said: "Demand across every area of the NHS is growing and patients' expectations are changing.
"We should all be proud of the progress the NHS has made in enabling people to enjoy longer lives. However, this comes at a cost, as more people are living with conditions that were not common 20 years ago. At the same time, we need to reduce our spend by £8.5 million in the next financial year.
"We're therefore reviewing all the healthcare services we commission to ensure we give patients the best value for money. This is a tough challenge, but we all have to play our part in reducing costs so that we can continue to retain high quality services that are sensitive to local need.
"Over the past year, we have been talking to residents, the voluntary sector and our health and social care partners about how we continue to provide everyone with the care that they need.
"We're now proposing to change, or stop funding, certain healthcare services and we'd like Wolverhampton people to tell us what they think. They can give us their feedback via our website at Type=links;Linkid=5920;Title=Wolverhampton Clinical Commissioning Group;Target=_blank;, email firstname.lastname@example.org or call 01902 444878."
The CCG set up an Efficiency Review Group, with representatives from its senior team, a patient representative and a lay member for public and patient involvement, in November.
Over the past 4 months, the group identified a number of services that are duplicated elsewhere, or don't provide enough value for money in terms of health benefits to patients.
The group has proposed changes to the following services, which would save about £2.3 million in total:
Interpreting service for non English speaking people at a GP or dental appointment
To provide better value for money, the group proposes changing this from a face to face service to a telephone service. This means patients won't need to book and wait for an interpreter, so GPs can deal with urgent queries when they arise. An interpreter would be available on the phone during opening hours. Face to face interpreting would be considered in some circumstances; for example, a patient with a severe disability.
Afro Caribbean Community Initiative (ACCI) service - empowerment and engagement
To avoid duplication, the group has proposed ending financial support for this ACCI local authority contract. This is because the CCG already invests in community development workers, whose roles cover patient engagement and the facilitation of representation.
Wolverhampton Voluntary Sector Council (WVSC) empowerment service
This service provides 25 support groups for people with mental health illnesses. The group has proposed ending financial support towards this contract, as the CCG already contributes to community development workers and a mental health specific group called Hear Our Voice. As the WVSC service mainly offers social care, the group felt it would be more appropriately funded by another organisation.
Age UK - Supportive discharge service
This service provides transport for people who have been assessed as vulnerable from New Cross Hospital to their home in Wolverhampton. As it is only used by a small number of patients, the group feels it doesn't provide value for money and is therefore proposing to withdraw funding for the service.
Community ultrasound service
The group has proposed ceasing these services, which are currently provided at 3 GP practices, because diagnostic services are already offered by The Royal Wolverhampton NHS Trust. This means patients would receive a more simplified service and would only be scanned once, resulting in better value for money.
Community benign skin lesion service
The group has proposed ending this service, which is provided by Parkfields Medical Practice, due to the low number of patients who use it. GPs can still refer patients who need this service via Choose and Book.
Community support schemes
Wolverhampton CCG provided training and education for care home staff members in 2014 to 2015 on a range of topics. However, the training was poorly attended and the Efficiency Review Group felt that it would be more appropriately funded by other organisations. It is therefore proposing to end funding.
Funding for The Royal Wolverhampton NHS Trust
The CCG currently provides additional funding for pressure mattresses, on top of the agreed contractual funding. The group is proposing that this extra financial support finishes, as it feels the current level of funding should be effective. Other areas of funding under review include some therapy services that are underused.
Prescribing products containing glucosamine and chondroitin
This medication is currently prescribed for some patients with mild to moderate osteoarthritis. However, NICE doesn't recommend the medicines, not all member practices prescribe them and studies have shown that exercise is a better option to alleviate symptoms. The group has therefore proposed that the CCG should stop providing them on prescription.
The CCG is continuing to review its budget to identify other potential savings, while minimising the effect on patients as far as possible.
- released: Thursday 12 March, 2015