NHS underfunding biting – Harrow CCG in dire situation – implications for health care

The NHS Harrow Clinical Commissioning Group (CCG) meeting behind closed doors is considering its Initial Budgets and Financial Plan 2017/18 which presents most concerning picture.
The CCG, which works closely with Harrow Council on health and social care issues, is responsible for planning and buying (commissioning) many of the health services needed by the 239,100 people who live in Harrow.
Key points of the part II report before the CCG governing body are:  an in-year deficit of £21.2m for 17/18; to deliver £17.5m of QIPP (net of the budget review) and that to deliver a recurrent surplus of 1%, a further £21.3m of QIPP will be required in 18/19.
The Quality, Innovation, Productivity and Prevention (QIPP) programme is a large-scale programme developed by the Department of Health to make huge ‘efficiency savings’.
The Harrow CCG is not solvent from inception and has been bailed out each year with support from NW London.
The level of cuts means that residents will have rationed care and London Northwest Hospital trust, which has a big deficit, will also be badly affected.
Payments to practices would be significantly scaled down to stay within the overall savings budget, meaning serious implications for the quality of patient care as GPs would provide services that fit within the limits of the money they get.
They will also be more concerned about meeting their prescribed indicators. For example, the GP practices will need to achieve the antimicrobial prescribing indicators and participate in the wider National Diabetes Audit (some Harrow practices already have concerning Care Quality Commission reports).
Irrespective of the budgetary decision, given the Harrow CCG’s significant role in health care at these challenging times, it requires robust leadership to demonstrate how well the CCG will commission, contract for, implement service changes and come out with the required equalities and clinical impact assessment of the proposed QIPP.
There appear reservations about the present leadership and management of the CCG. Seemingly not entirely happy Chief Operating Officer left last December and now an interim is in place. Previously we have reported shaky confidence in Harrow CCG transparency’ at the governing body level.
They cannot fudge the situation any more!