• West Yorkshire and Harrogate to standardise approach to elective care across 11 CCGs
  • Orthopaedics and ophthalmology are the first two specialties the programme will focus on due to the wide variation in RTT

Commissioning leaders are aiming to save £50m a year by standardising policies in elective care across their sustainability and transformation partnership footprint.

The West Yorkshire and Harrogate Joint Committee of Clinical Commissioning Groups has agreed to work towards creating a standardised approach to elective care across its 11 CCGs.

Standardising commissioning policies was one of the joint committee’s main priorities when it was set up earlier this year.

A briefing paper for the joint committee’s meeting on Wednesday said the programme will be delivered in conjunction with the West Yorkshire Association of Acute Trusts’ elective care programme and is expected to be completed by 2020-21.

Elective orthopaedics and ophthalmology are the first two specialties the programme will focus on due to the wide variation in hitting the referral to treatment target.

The briefing said: “It will help to manage demand for elective care through health improvement and prevention, and deliver the most efficient elective care releasing capacity in the system to address unmet need.

“This will increase the responsiveness of services to patients in West Yorkshire and Harrogate, improve patient access, and support achievement of clinical ambitions such as 18 week referral to treatment targets.

“It is agreed as an underpinning principle that not all CCGs will move to revised policies at the same time. The expectation is that there will be a rolling programme of implementation, resulting in an end point where all CCGs are taking the same approach.”

The elective care programme will have four key workstreams:

  • Supporting healthier choices: looking at ensuring patients are fit to be assessed for surgery and offer help with smoking cessation, weight loss, alcohol and mental health problems;
  • Clinical thresholds and policies: to reduce demand by 10 per cent through standardising practices for referral and treatments, starting with procedures of limited clinical value;
  • Outpatients: to reduce outpatient follow ups without procedure by 20 per cent;
  • Prescribing: investigating how to reduce unwarranted waste and variation to bring down the amount spent on high cost drugs.

Further analysis of the current services and gaps across the footprint, proposals for orthopaedics and ophthalmology, and a list of procedures of limited clinical value are expected to be presented to the committee at its meeting in March.

On Wednesday, joint committee members agreed:

  • the approach to a new elective care programme;
  • to standardise commissioning policies for procedures of limited clinical value; and
  • to develop new approaches to outpatient services in elective orthopaedic surgery and eye care services.

The briefing added: “Much of this work is already underway in each place and this presents an opportunity to agree a common approach.

“The ambition is to move to implementation on the initial aspects of the work programme in the first quarter of financial year 2018-19; however, this needs further development in conjunction with the programme leads from each of the places.”

The committee warned there was a risk “trust, relationships and collaboration” between CCGs and providers was “insufficiently mature to support the scale and pace of change required in the programme”.

A spokeswoman for the committee said the benefits of the programme were not driven by finance, but “about a refocus and reinvestment around the way we work together with patients to prevent ill health and improved health outcomes”.

She added: “The committee agreed there is an opportunity across [the region] planned care to standardise ways of working so treatment is fair and consistent.

“This includes supporting people to make healthier choices, reducing variation and inconsistency in policy and practice. The aim is to achieve £50m recurrent savings by 2021 across four work streams.”