The Chief Finance Officer, Darlington NHS CCG gave a PowerPoint Presentation which provided an update on the CCG’s Financial Plan 2018/19 and included final allocations - money the CCG has to spend; summary financial plan – what the CCG is planning on spending; efficiency plan - what savings the CCG have to make to balance the books; and risk and mitigations – scenarios if the planned spend worsens. It was confirmed that Darlington CCG had balanced the books last year and was in a healthier state than some neighbouring authorities.
It was stated that the CCG could not spend above the allocation it received from National Health Services England and that the allocation was split into three areas of programme for patient care, primary care delegated for GP practices and running costs for the management of the CCG. The majority of spend was in the area of programme for patient care and whilst the CCG cannot overspend on running costs for management it could underspend and reallocate.
Particular reference was made to the CCG’s expenditure and demands for services which outweigh the allocations received resulting in an efficiency programme, developed by benchmarking against peers and looking for areas where the spend is significantly higher, to balance the books. Benchmarking includes comparing pathways in order to get the best outcome for the spend and the patient.
It was explained that the CCG had to plan for expected inflationary increases and that the minimum wage increase had had an impact in the Care Home Sector.
The Chief Finance Officer gave a full explanation of the CCG’s Summary Financial Plan 2018/19 including National Tariffs and Formulas for services, last year’s spend, net tariff uplift and contingency plans.
Once the Efficiency Plan has been developed it is assessed by the CCG to identify how it would manage the financial risk if certain scenarios, for example, increased activity in the acute Trust, were to happen. It was confirmed that the focus for efficiency plans was within acute spend, prescribing in primary care and continuing healthcare.
It was reiterated by the Chief Finance Officer that the plan was reasonable and that Darlington was in a less risky position as opposed to other CCGs in the area. The CCG had a block contract with CDDFT and the CCG and The Trust had to work together to drive efficiency and collectively drive transformation and cost.
Discussion and challenge ensued on ineffective procedures and whether the decision was made by the clinician and that efficiency did not drive clinical need. The Chief Finance Officer confirmed that Public Health England and NHS England were looking at procedures where treatment should not happen, such as removal of tonsils, unless there were exceptional circumstances.
Following a question it was confirmed that there would be no delays as waiting lists had to be maintained and that the Referral Management System had removed people who did not need a surgical intervention.
Concerns were raised that people were purchasing essential equipment as Mediquip were not providing like-for-like, although it was accepted that the NHS should fund any medical needs which were different from a ‘want’.
Overall Members were pleased with the financial position of Darlington NHS CCG and have requested regular updates on its financial position.
RESOLVED – (a) That the thanks of this Scrutiny Committee be extended to the Chief Finance Officer for his informative presentation.
(b) That this Scrutiny Committee welcomes the overall financial position of the Darlington NHS Clinical Commissioning Group.
(c) That this Scrutiny Committee be kept updated on the financial position of Darlington NHS Clinical Commissioning Group.