NHS boss vows to break even next year - but financial challenge could result in job losses

Shropshire Clinical Commissioning Group (CGG) was recommended for special measures, when it revealed it was expecting to record a £10.6 million deficit by the end of the current financial year.

Today Brigid Stacey, the CCG's acting accountable officer, said she hopes to work on this deficit in order to break even next financial year.

She said: "When I came to look at the finances it became apparent to me that some of the financial plans that were in place were optimistic.

"Some of the assumptions on some of the savings they could make were not going to be realised. So we had to re-define what the realistic picture was going to be. We have done that now.

"Our plan is to break even next year, for 2016/17, so coming from an in year end defect of £10.6 million is quite an achievement. That is our plan.

"I think there was an emerging financial position which has become apparent. It was not the only CCG nationally which is in trouble. The challenge of the financial position in the NHS is becoming greater and I think we now know the size of the problem and have plans to delivery it.

"I think it is a challenged health economy and it has been a challenged health economy for a number of years. When I was in North Midlands we were overseeing this economy so I am not new to Shropshire and I know the size of the challenge. That was not a surprise to me. However what I am really impressed by is the commitment of local leaders and staff to really get on board. They know the size of the problem now and are committed to getting it sorted."

Ms Stacey said in looking at ways to save money, they could not guarantee there would be no job losses.

She added: "We can't guarantee there will not be redundancies but the areas we are looking at is around pathways of care and about transforming services.

" Some of our services are quite traditional and if we transformed those services and made them closer to home for patients and their families, out of hospitals which is very expensive, and move the care closer to home we will actually get some savings out of that. We will have improved services and got some savings.

"One of the things we want to really look at is how we utilise our community hospitals. We want to increase the offer of services they have.

"One of the things I am really clear about is that we have to work together as a system in health and social care. And that is really important as that is the only way we are going to address the defect is collectively.

"We have brought in a turnaround team and the message I have given to them is that we need to be in a finally sustainable position but not to the detriment of other people in the health and social system. So we can't push the defect around the system as that is not going to help anybody. We have to address the system defect in order to move on with Future Fit.

"Next year we are planning a big public engagement under the umbrella of Future Fit."

Future Fit will determine how accident and emergency should be organised and is likely to lead to the closure of one of the existing units in Shrewsbury and Telford.

A preferred option for the location of a new single A&E unit for Shropshire was due to be announced by health bosses in October.

But the board said neither option properly addressed a £20 million-plus deficit and the decision was deferred.

Ms Stacey added: "I think Future Fit is great, I think it is a really good vehicle for transformation. The one thing that this health economy has really majored on is the service transformation plans and they are much further ahead than a lot of other communities that I have seen nationally.

"I think the fact it has such much patient and public involvement is great and the fact that it has been clinically lead. We know it is the right model and we now need to get on and make sure we can afford it.

"We have now set up a system deficit reduction plan so all the directors and the accountable officers got together to look at understanding the size of the problem, because previously the deficit they were trying to address was just Shrewsbury and Telford Hospital Trust, now it is the system wide deficit which includes ours - so it is much bigger. We are just going through to validate that and understand the size of it. We now have a number of plans which we now need to work up going into next year."

Future Fit leaders will now meet again in the New Year to discuss the next step and financial plans.

Meanwhile the finance health bosses will be drawing up plans to show how the deficit can be reduced to zero in five years.

And while this is going on all members of the health economy have come up with a winter plan to help drive down the number of people attending A&E.

Ms Stacey added: "We have a very good winter plan. We are on track for delivery with that. We have good system buy in from all the commissioners and providers.

"We met with NHS England on Friday and they think we have a good plan so they have assured the plan.

"It is a system wide set of plans looking at admission avoidance and flow through the hospital. We are looking at targeting the over 75s preventing them for going into hospital and we are looking at better integration between community and acute services.

"One of the things we are doing to drive admissions down at the hospitals is the over 75s scheme.

"This is where we have a GP situated with the ambulance service so if there is an over 75 year old in their home calling an ambulance the GP will go out with the paramedic and actually try and treat the patient at home. They are local GPs we are basing it at the Shrewsbury locality in the first instance.

"This is a pilot we will see how it goes. If it is a success then we will roll it out Shropshire wide."