Surgery warning to smokers and obese

Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) is set to announce a series of 'urgent and necessary' measures to address a worsening of its financial situation.

Last year the CCG returned a £14.5 million deficit (known as a control total) and this year it had been predicting the same.

But its confidence in meeting this at the end of the current financial year has gradually declined as the situation has become clearer; in short, demand for services is outstripping what it can afford.

Whatever the actual cause of the increase in demand, it is having a serious effect on the financial position of the CCG and if it fails to deal with it now, services will suffer.

Rebecca Harriott, the CCG's chief officer, said it would be prioritising services in the NHS Constitution.

“We must act to protect essential services through our busiest winter months and ensure that care is there for our patients when they really need it,” she said.

“The CCG has already begun to implement a series of measures designed to improve efficiency in the system and encourage patients to contribute to improving their own health outcomes.

"This includes the following:

Requiring morbidly obese patients to lose weight prior to routine surgery
Requiring smokers to quit for at least six weeks prior to routine surgery
Introduce criteria-based approval for routine procedures such as hernias, botox injections and cataracts
Reduce unnecessary consultant to consultant referrals
Suspend treatments where there is little or poor evidence of outcomes

“These measures bring the CCG into line with similar organisations in the NHS. However, they are not enough.

“The CCG is working up a series of measures to prioritise those patients most in need, while at the same time, increasing efficiency in the wider system – and the CCG itself.

"Our clinical chairs (who are family doctors) and managing directors are now busy working up proposals, in collaboration with NHS England and others, so that we can submit a paper to the next Governing Body on November 5."

This paper will be published on the CCG’s website on October 29.

The CCG has already saved £2 million in its running costs but it is now intending to make the organisation even more efficient - cutting more internal costs.

The CCG is making it clear that it intends to prioritise those services and requirements laid out in the NHS Constitution.

They include (but are not limited to):

Consultant-led treatment within a maximum of 18-weeks from referral for non- urgent conditions
Maximum four-hour wait in A&E from arrival to admission
Maximum 7 day wait for follow-up after discharge from psychiatric in-patient care
Being seen by a cancer specialist within a maximum of two weeks from GP referral where cancer is suspected
Maximum 62-day wait from referral from an NHS cancer screening service to first treatment
Patients waiting for a diagnostic test should have been waiting less than 6 weeks from referral
Ambulance trusts to respond to 95 per cent of category A calls within 19 minutes of a request being made

Rebecca Harriott added: "To meet the challenge of prioritising patient need while at the same time meeting our control total, the Governing Body will be asked to temporarily change how we work.

"We are intending to split our management and administration resource between ‘business as usual’ and ‘in-year priorities’.”