Shropshire NHS finances 'among worst in the UK'

Auditors described its review of Shropshire Clinical Commissioning Group as the most difficult they had carried out.

Accountant firm Grant Thornton is responsible for looking at around a third of the UK's CCGs.

Its spokesman Terry Tobin told CCG members: "This audit to be totally blunt and brutal was a very difficult audit, probably the most difficult Grant Thornton has done at CCGs – that is some statement."

Mr Tobin said the audit, which covered 2015/16, had resulted in an adverse "value for money" rating, something only five per cent of CCGs receive. He told Shropshire CCG's governing board members: "That is not a group you want to be in."

Mr Tobin criticised CCG staff in Shropshire, saying a number of problems had been encountered when they were putting together the annual audit letter, including not receiving prompt answers to questions or papers to support statements.

The CCG was warned it faces a "really really difficult few years ahead" as it tries to get a handle on a predicted budget deficit of £18 million, which means it has to save £11 million by the end of the year.

Mr Tobin said: "There was a deficit of £11 million last year but what was most worrying was that there was such a huge swing from the start of the year to the end of the year, and most of that was continuing healthcare, and what that says about the budget setting process."

The audit letter had stated "we were not satisfied that the CCG has made proper arrangements to secure economy, efficiency, and effectiveness in its use of resources for the year ending March 31, 2016".

David Evans, accountable officer for Shropshire CCG, said: "I think it is very challenging to meet the target by the end of the year but we will."

The CCG's governing board meeting, which took place yesterday, heard from Andrew Nash, chief finance officer, who said the organisation had reached its agreed level of agreed overspend in only the fourth month of the year.

He said: "Overspending does not increase the resources available to the CCG, in fact it reduces them in future years. Overspending is debt and we have to repay it."

Mr Nash said that the CCG had no option but to live within its means and reduce spending.

He said: "We cannot expect additional funding is suddenly going to drop down into our laps.

"There is a national debate about funding for the NHS but nevertheless we have to deal with the resources we have got. The funding formula is not going to change any time soon."

Mr Evans told the meeting that one of the actions which has been taken is that any out of area spending now has to be authorised.

He said: "All out of area providers have been written to and told that unless they seek prior authorisation they will not receive payment for those activities."