In their main budget meeting on 6th April, open to observers from the public including BPV, Brent CCG Governing Body nodded through the 2016/17 draft budget of £430.4 million (3.05% increase on 2015/16) with a projected underlying surplus of £3.1 million without any challenge or vigorous questions at the meeting about how the budget pie should be divided up between clinical needs. The budget was presented by the new Chief Financial Officer, Neil Farrelly.
The overall position for the financial year just ended is an expected underlying deficit of £0.1 million, but an actual surplus of £21.9million. NHS England rejected the CCG “recovery” plan projecting a small deficit.
The CCG recognise in their budget risks from clinical demands beyond their control e.g Accident and Emergency.
A major express assumption in the budget is the delivery of the NW London NHS ‘Shaping a Healthier Future’ project. There must be much uncertainty about these assumptions because the Business Case for this project with its large capital requirements has not yet been published or approved by the Government. This includes Brent CCG approving the NW London collaboration agreement that financially stronger CCGs will support financially weaker ones over SaHF. This appears to be a major departure from the principle of local CCG financial stand-alone self-sufficiency.
There were some gentle requests from Governing Body representatives, including Healthwatch Brent leader Ian Niven and Brent CCG engagement Lay Member Nick Young, about the need for the CCG to publish clearer justification for the Quality Innovation Productivity and Prevention (QIPP) requirements for £11.7 million salami slicing cost cutting as to resulting benefits for patients. Sarah Mansuralli towards the end of the meeting gave a short eloquent justification for the QIPP programme including 3 examples of where she suggested QIPP changes have improved clinical management of patients and at the same time achieved long term cost savings for the NHS: stroke rehabilitation, falls prevention and ‘repatriation’ of mental health patients placed outside the borough to be back in the borough nearer their homes where they can more easily obtain family support.
BPV welcomes all innovative projects that improve the quality of care for patients but we just observe that identifying genuine savings from such projects may stretch the imagination. For example few elderly patients may realise that if they do NOT fall down when expected this counts as a saving to the NHS! No wonder Simon Stevens, CE of NHS England, finds it so hard to explain where the current alleged “efficiency savings” of £22 billion are coming from.
The Brent CCG Chief Executive Rob Larkman did not attend the meeting.
Peter Latham BPV Steering Group member and Chair Willesden Locality PPG