- Cambridgeshire and Peterborough CCG to discuss controversial service cuts, including to IVF
- CCG also recommends axing funding for range of older people’s services
- CCG forecasting £75m deficit despite original £25m control total
A financially-troubled clinical commissioning group forecasting a £75m deficit has recommended a multimillion pound package of cuts, including permanently axing IVF for its population.
Funding for a range of community services supporting older people and patients with long-term conditions, including an emergency rapid response team, could also be dropped under proposals to be discussed by the Cambridgeshire and Peterborough CCG board tomorrow.
Other services the CCG has recommended cutting funding for include Dial-a-Ride, grants for multiple charities, a brain injury rehabilitation centre, ophthalmology services, and dermatology services (see box below for full list).
The CCG’s board papers said the cuts were part of an ambitious £32.7m savings plan needed to hit its £75m deficit target, which is £50m worse than the original £25m control total set by NHS England. NHSE has now agreed to a £75m target, the CCG told HSJ.
A report on its IVF services said it had saved £731,000 between September 2017 and March 2019 by suspending the service. It recommended permanently ending the service due to “finite resources” and other funding priorities. It is one of only a handful of CCGs funding no IVF at all.
The report comes just weeks after health minister Jackie Doyle-Price wrote to CCGs on 17 June to warn them it was “not acceptable” to cut IVF services – a move taken by only a handful of CCGs to date, some of which have subsequently rowed back.
Such cuts caused an “unfair” postcode lottery, “psychological distress for patients” and “untold reputational damage” to the NHS, the minister said.
“I cannot emphasise enough that it is not acceptable for CCGs to offer no routine access to fertility services,” she added, according to the Observer newspaper.
The service cuts were identified as part of a deficit analysis which warned the CCG was wasting around £20m because of “overlapping commissioned services that results in duplication and poor efficiency,” the board report said.
It published a paper on its community services review, which said it needed to cut the services’ £112m expenditure by £4.1m. It has so far identified £2.8m of those savings.
The CCG has also proposed cutting its joint emergency team, which provides rapid response support for older people and patients with long-term conditions – a service it has long heaped praise on. The review proposing its funding should be cut added it “provided excellent patient facing care for patients”.
The CCG’s £75m deficit, set out in a plan it submitted to NHSE in May, was part of Cambridgeshire and Peterborough’s Sustainability and Transformation Partnership systemwide planned £192.5m deficit.
Local providers have raised concerns. Cambridgeshire and Peterborough Foundation Trust which provides the JET service said axing the service would fundamental patient safety risks.
CPFT chief executive Tracy Dowling said: “[The trust fully understands] the need for commissioners to closely examine every area of its expenditure.
“However, we are deeply concerned for the safety of patients in the community should the recommendation to decommission the [JET] be decided. This service is more than an admission avoidance service – it is the urgent care community service.
“We have written to the CCG to outline the view of CPFT on the potential impacts of such a decision on both patients and on our dedicated, frontline NHS staff who are currently employed to deliver this specialist service.
“This service sees approximately 10,000 patients a year and on average patients are receiving urgent community care within two hours of making a call. ”
The CCG has been asked for comment.
The CCG said it recommended decommissioning or ceasing its funding for:
- The Stroke Association;
- The Alzheimer’s Society;
- The Carer’s Trust Cambridgeshire & Peterborough, Norfolk;
- The Health and Wellbeing Network;
- The Evelyn Community Head Injury Service;
- RSS Ophthalmology;
- Evolutio – ophthalmology;
- DMC – dermatology;
- Oliver Zangwill (a brain injury rehabilitation centre); and
- The joint emergency team.
The CCG would like to “renegotiate service provision and/or payment for the following”:
- The Care Network;
- Cambridge Hearing Help;
- ACES Ophthalmology;
- Minor Eye Conditions;
- Concordia ENT;
- Sawston Microsuction;
- ENT GPSI (Charles Hicks Practice);
- Dermatology GPSI Buckden/Wisbech;
- Diagnostic Healthcare (formerly Excel);
- Global Diagnostics;
- Dexa scan (multiple providers);
- Specsavers Direct Access Audiology;
- Inhealth Audiology; and
- Vasectomy (various contracts).
- CAMBRIDGESHIRE AND PETERBOROUGH FOUNDATION TRUST
- CCG List
- Community services
- Department of Health and Social Care (DHSC)
- East of England
- HSJ LOCAL
- Long term conditions
- NHS Cambridgeshire and Peterborough CCG
- NHS England (Commissioning Board)
- Older people’s services