• Fresh legal directions given to troubled NEW Devon CCG
  • Deadline for submission of 2017-18 operating plan is Friday
  • CCG’s cumulative deficit now stands at £120.5m 

The largest clinical commissioning group in the country has been given fresh legal directions over its financial management, amid a worsening of its cumulative deficit.

NHS England has imposed several instructions on Northern, Eastern and Western Devon CCG, which has been in the region’s success regime since 2015, and is yet to agree its operating plan for 2017-18 with regulators.

The deadline for submitting the plan is Friday.

The updated directions, which took effect in late March, replace previous directions from August 2015.

They include:

  • The financial recovery plan and any amendments to it shall continue to be subject to NHS England approval.
  • NHS England may direct the CCG in any other matters relating to the financial recovery plan.
  • NHS England could dictate the process to be followed by the CCG in making appointments to its executive team or the “next tier of management”.

The CCG’s cumulative deficit since 2013-14 now stands at £120m, after it ended 2016-17 with a £42m deficit.

In 2016-17 it had forecast a cumulative deficit of £107m.

The region, which has been warned it could become subject to the new “capped expenditure process” devised by NHS England and NHS Improvement, has been ordered to come up with affordable operating plans by Friday.

The plans will be reviewed with national directors at NHS England and NHSI later this month.

The CCG and the NHS providers in the NEW Devon footprint had a joint financial plan for 2016-17.

Neither the CCG nor the providers could identify further savings without “having a severe impact on patient care”, CCG governing body papers said.

In February, the CCG confirmed plans to reduce the number of inpatient beds across four community hospitals in its eastern locality from 143 to 72.

For 2017-18, one of the main providers on the patch – Plymouth Hospitals Trust – has launched a £40m financial improvement programme, which includes workforce redesign.

HSJ asked the CCG what its financial forecast and savings target would be in 2017-18, but a spokeswoman said it would be inappropriate to respond to questions relating to 2017-18 because their plans have not yet been approved.

South Devon and Torbay CCG is also under legal directions.

  • Article updated at 3.33pm, May 5, after new information was provided by the CCG.