Shropshire’s already troubled NHS faces an escalating financial problem, combined with runaway growth in emergency admissions, even as health chiefs try to push through the closure of A&E services at Telford’s busy Princess Royal Hospital – a move being challenged by Telford & Wrekin council.
Many other rural CCGs across the country will also be nervously grappling with the pressures of the coming financial year. The situation facing Shropshire is revealed by a Medium Term Financial Plan published by Telford & Wrekin CCG in advance of their March Governing Body meeting, which shows the area facing a financial gap next year of £50m. Previously the CCG (unlike Shropshire, which is hoping to hit its control total deficit of £13.3m, to carry a £60m cumulative deficit into 2019/20) has always been getting by financially.
There is also a huge increase in emergency/non-elective activity, which will not have been helped by axing the out of hours primary care services provided until last September by Shropdoc.
The T&W CCG paper shows A&E attendances are 9% above plan, ambulance conveyances 10% above plan, and emergency admissions a massive 16% above plan (and above 2017/18 activity levels).
This means actual demand is already far greater than provided for under the highly controversial “Future Fit” proposals to scale down acute hospital services and “centralise” emergency services in Shrewsbury for the large rural county.
T&W CCG warns that the scale of the financial problem is so great it is beyond the scope of the CCGs to deal with it: “providers and commissioners need to work collaboratively to identify transformational changes…”.
The CCG admits that the target of £9.6m for ‘QIPP’ savings in the coming year is “higher than any QIPP that has been delivered in any previous year.” However £4.2m of the £9.6m cuts have not yet been identified.
A third of the “savings” have to be made from acute sector, the Shrewsbury & Telford Hospitals Trust, which itself was already facing a projected £24m deficit this year, £5m above its control total.
The Future Fit plan hoped to deliver a marginal surplus of only £2.6m for the Trust, but this is now wiped out by the additional cuts to be imposed by T&W CCG.
Campaigners warn that Shropshire CCG, which meets a day later but has not yet published its March papers, will have to aim for an even higher saving from acute services, posing the Trust with even deeper financial problems.
It’s now clear to all that the Future Fit plan’s sums don’t add up either financially or in terms of demand and capacity. The Trust is currently ranked 130 out of 131 for its performance on A&E services and if the caseload continues to exceed planned levels while funding is cut back there is little hope of improvement.
Cllr Andy Burford, co-chair of the Joint Health Overview and Scrutiny Committee of Shropshire and Telford & Wrekin councils told The Lowdown:
“On the face of it these new CCG figures are very worrying. We have a JHOSC meeting coming up soon, and we will be asking some searching questions to establish what the real financial position is for health care in our area.”
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