FINANCE Review highlights 'highly challenging' time ahead

Published: 01/12/2005 Volume 115 No. 5984 Page 13

A review of services in Shropshire has called for major changes to ensure the local health economy saves£37m per year over the next three years.

The strategic services review has laid out a number cost-saving measures including:

designating one hospital in Shrewsbury and Telford Hospitals trust as primarily emergency, and the other primarily non-emergency, with limited ability to treat less serious emergency patients;

closing one or more of the community hospitals at Ludlow, Whitchurch and Bridgnorth;

improving the rate of day surgery and theatre usage at hospitals;

making large savings in primary and community-based services.

The report outlines three options for saving money. The first would mainly impact on the acute sector, the second mainly the primary and community services and the third would affect all sectors.

But only the maximum predicted savings in all sectors would eliminate the£25m a year deficit in the local health economy plus an annual underlying deficit of£12m, which will account for£36bn by 2009.

The options are now being discussed by stakeholders, who may come up with other ways to save the money. A formal consultation will start on the resulting recommendations early next year.

Project director Clive Walsh said: 'It is a tough job but the thing that impresses me is that the four health organisations are absolutely determined to work together.' He said the report had revealed some complex issues which were hard to explain: 'There is a curious conundrum - we are spending more than average on primary and community care but we have a higher hospitalisation rate.' The report, prepared by Finnamore Management Consultants, highlights a range of potential savings for each action. For example, savings in prescribing, community nursing and general medical services could be as high as£17.3m a year or as low as£2.3m.

Risks to achieving some of these savings are also flagged up, such as not being able to change prescribing patterns.

If the maximum savings were made across the board, then the health economy would be£39.5m a year better off - which would bring it into financial balance and allow debts to be paid off. The report describes this as 'highly challenging'.

However, if the minimum savings from all the changes were made, only£5m a year would be saved.