• CCGs plan five per cent cut to non-acute services in “non-negotiable” budget plans for 2018-19
  • Cuts will exclude primary care, mental health but impact on community services and the Better Care Fund
  • The two CCGs had predicted a £57.4m budget deficit for 2018-19

Two clinical commissioning groups could cut spending on non-acute community services by five per cent to tackle concerns over budget deficits.

Hastings and Rother CCG and Eastbourne, Hailsham and Seaford CCG originally predicted a £57.4m deficit in 2018-19 but the governing bodies were unable to agree a budget at their meeting in March.

Now they are being told there is a “non-negotiable” offer of a £32m deficit across the two organisations which would be matched by £32m from the commissioner sustainability fund, bringing them to a breakeven position.

To help get to this point, the governing bodies are being asked today to back a five per cent cut in non-acute spending, excluding primary care and mental health.

It would reduce the value of the trust’s contracts for community services with East Sussex Healthcare Trust by £2.5m, integrated community equipment services and the Better Care Fund by £900,000 each, and would mean adopting “stretch” targets for medicines management, continuing healthcare and funded nursing care.

The CCGs are reviewing some investments in services to keep people out of hospital, ambulatory care and primary care streaming at hospitals.

In a report to the two governing bodies, which hold joint meetings, chief finance officer John O’Sullivan said the five per cent reduction would be “a short term measure to enable the CCGs to reduce the remaining gap in our 2018-19 plans and be in a better position to plan for the next two years.”

In a statement, the CCGs said that they needed to reduce expenditure overall by £18m – 2.9 per cent of their allocation – and would be discussing the non-acute budgets with providers. All proposals would have quality impact assessments carried out.

“The investments in community services made in 2017-18 are being reviewed with our provider to ensure value for money from the services, as would be expected with any investment programme. The outcome of the review will inform ongoing investment or disinvestment decisions. The community budget for 2018-19 is £49.7m and the proposed reduction of £2.5m is five per cent of this total,” they said.

“The term non-negotiable should not be taken in a literal sense of having conditions imposed from outside. It is rather an expression of the determination of the leadership of the CCGs to embrace the opportunity presented by the revised control total, and to do everything possible to return the local health and care system to financial sustainability by working even closer with our East Sussex Better Together partners.”

East Sussex Healthcare Trust said that all system investments made in previous years were being jointly reviewed and any decision on changes would be made by the East Sussex Better Together partners – the trust, the CCGs and East Sussex County Council.

“Our first priority will, of course, be to ensure that there is no adverse impact on patients and staff, and any financial impact for the trust will be managed through the East Sussex Better Together governance process,” it said.