STRUCTURE: A plan to redesign dermatology services in Buckinghamshire has been delayed by up to five months due to consultation on a proposed service change and contract negotiations.

The plan is part of the local quality, innovation, productivity and prevention programme.

It had originally intended to be completed in June. However primary care trust board papers said: “This project has reported 4-5 months slippage on three key milestones, due to consultation on the proposed service change (closure of inpatient capacity) and delays in contract negotiation.

“Discussions with the service provider are continuing regarding the proposed service model and affordability.”

The impact of lost savings as a result of this slippage is mitigated by a reduction in the required in-year investment in the new service and non-payment of CQUIN linked to the proposed service change.

An inpatient ward closure was pushed back to October, as was the implementation of “tele dermatology” in primary care. The establishment of a community dermatology service was delayed until November. The slippage cost £375,400 in unrealised savings.

The lost savings were mitigated by a cut in the required in-year investment in the new service and the non-payment of provider incentives linked to innovation.