• Group of eight commissioners grappling with year-end underlying deficit of over £100m
  • Budget for this year puts the alliance £66m away from its control total
  • Cost of hosting GP at Hand now put at £22m

The North West London healthcare economy must cut costs by “about £100m” as demand pressures grow, according to its finance director.

The alliance of eight clinical commissioning groups in north west London ended the year with a £56.7m deficit – missing its control by over £47m.

Paul Brown, chief finance officer, told the May committee meeting of the eight CCGs the year-end deficit was in addition to “about £50m worth of non-recurrent measures that we took – so really the underlying position was over £100m.”

The CCG alliance has put forward a budget to end 2019-20 with a deficit of £87.2m, leaving it a gap from its system control total of about £66m.

“We don’t think it is possible in this financial year to achieve financial balance,” Mr Brown added.

The alliance counts Hammersmith and Fulham CCG among its number, host to the digital GP service GP at Hand that provides care to patients registered in other parts of the country.

The CCG alliance estimates “the value of the healthcare provided to those non-north west London patients is just short of £22m. So, a very sizeable amount,” Mr Brown said.

The eight commissioners hope they can reach an agreement that means they can recoup the £22m, which would leave them £44m away from their system control total.

“We have not yet had agreement that that will be funded or that we could recharge it to the CCG from which those patients originated but we’re continuing to take that up with our colleagues at the centre,” he said.

“We have now got to the point where we have agreed the number, which is a step forward,” he added.

In  March, the CCG alliance reported the costs of hosting GP at Hand was £10.2m in 2018-19 and that service cuts could not be ruled out as a result.

North west London will have a system recovery plan in place by the end of June he added. “Ultimately, jointly with the providers, we have to take out about £100m of costs out of north West London,” he said.

NHS England is no longer thinking of putting the most troubled CCG in the alliance, Harrow, in financial directions because the area’s financial woes are systemic and not isolated to any one commissioning group, the May meeting also heard.

Currently, the alliance is “undertaking reorganisations in a number of departments across the eight CCGs in north west London,” a spokesman said.

Three staff members are “at risk of redundancy” while all currently vacant job posts are being reviewed. Any posts thought to be “business critical” will be released for recruitment.

All the vacancies are ring-fenced for existing staff at risk of redundancy so should posts be re-opened and any of the at-risk staff are considered suitable for the posts, then they will be “slotted into these roles”.