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Health Matters - Financial challenges

Health Matters - Financial challenges
08 November 2017

Regular readers of this column will know there’s a growing gap between the funding we get from NHS England and the money we need to carry on as we are.

You may find that hard to believe when I tell you that we have £280.5m to spend on healthcare in 2017-18. It sounds like a great deal of money yet it’s less than the cost of one hospital admission for each of the 204,000 people we serve. What’s more, it’s £8m less than we need according to government calculations.

To try to reduce our debt, we’re working hard this year to save £17.9m, or nearly four per cent of turnover. But, even if we manage it, we’ll still end the year with a debt of £13.4m agreed with NHS England.

Yet our end-of-year deficit is more likely to be £23.1m. That’s because there’s a gap of nearly £7m that we will not be able to bridge unless we make major changes to the way services are delivered. Such changes would almost certainly require public consultation and approval in principle by NHS England. Discussions have been underway for some time and it’s likely that an announcement will be made early next year.

In the meantime, we have made important progress with improving efficiency and cutting costs. For example, our 23 GP practices have reduced hospital referrals by enhancing services available in primary care including promotion of healthy living and increasing support for people with long-term conditions to help them take good care of themselves. We have reduced stockpiling and wastage of medicines by transferring responsibility for the ordering of repeat prescriptions from community pharmacies to patients.

We have stopped funding the prescribing of over-the-counter medicines for common, self-limiting ailments like coughs, colds and sore throats.

We have also restricted access to certain procedures of lower clinical priority including revised thresholds for treatments considered cosmetic and for sterility and fertility treatments including reducing funding of IVF from three cycles to one – in line with many other CCGs.

Further plans for 2017-18 include:

  • Following a process called NHS RightCare, which is helping us find the treatment approaches offering the greatest opportunity for improved clinical effectiveness and value for money
  • Introducing a referral management system that will ensure a more consistent approach to referring patients to secondary care
  • Fully embedding our health optimisation policy, which is helping patients get in the best possible shape for planned surgery – reducing the risk of costly readmissions.


Having talked about our financial challenges, I’d like to finish on a brighter note by thanking readers for choosing self-care when appropriate and not putting unnecessary strain on your GP or A&E. I’d also like to stress that we’re fortunate in Eastern Cheshire to have services that continue providing high-quality care.