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Local NHS organisations work together to bridge financial gap

The organisations that plan and fund NHS services in the Nottingham area say that a new approach is needed to meet the increasing challenges of funding health services.

CCG leaders estimate that currently there is a collective gap of £31 million this year between the money that is available and the cost of providing NHS services for the 750,000 people who live in Nottingham and in the surrounding areas that are covered by Nottingham City, Nottingham West, Nottingham North and East and Rushcliffe Clinical Commissioning Groups (CCGs).

Dr James Hopkinson, Clinical Lead for Nottingham North and East CCG explains: “We need a new partnership, including one with our patients and citizens, to try to meet the growing financial gap.

“As clinicians and as managers of our local NHS resources we are determined to ensure that the people in greatest need can rely on high quality services and appropriate support.

“There are also things that we can all do as individuals to make the best use of NHS services, improve our health and support our communities to be healthier.

“It will take a concerted effort from everyone to try to put our local NHS budget on a firm footing, to ensure that we spend our money wisely and that we live within our means.  It’s now time for that concerted effort.”

Doctors are already working with managers on plans that will improve health services, making them more efficient and better value for money.  These include:

  • Redesigning services, such as those for patients with stomach/digestive (gastro-intestinal) conditions, to ensure patients are seen at the right time, by the right health professional to reduce of unnecessary tests and appointments. This more streamlined service from GP surgery to hospital consultant will be better for patients and also cost less
  • Organising services nearer to home for patients by using new information technology
  • GPs able to access diagnostic tests for their patients directly rather than following a hospital visit

The CCG leaders hope that initiatives such as this will go towards meeting the current financial deficit.  But increasing demand for some services this year means that already resources are being stretched to their limit and the existing savings may not be enough. 

Dr Guy Mansford, Nottingham West CCG Clinical Lead said: “There is a perception that the NHS is free, that it’s not real money. It is very real and it’s being paid for by you and me and we all want to see the NHS continue to provide appropriate care when we need it. To ensure this happens locally we’ve got to spend every pound wisely”.

High demand for a range of services including Accident and Emergency, routine surgery, hospital care, pain management and escalating costs for funding care packages for patients in their own home, with complex needs or who need nursing care (NHS Continuing Healthcare and NHS-funded nursing care) are adding to the total NHS costs.  There are no additional resources to meet these increasing costs. 

As a result the CCGs are asking patients to support the savings by using the right NHS service at the right time. For example:

  • Use your local pharmacy first for advice and commonly available medicines, which can now be bought over the counter e.g. Antihistamines for allergies such as Hay Fever cost £1.80 for a two week supply at supermarket pharmacies.
  • Only order medicines that you are actually going to use (it is estimated that over £2 million per year is wasted in unused medicines locally)
  • Attend any appointments and contact the service if you cannot attend so that the appointment can be offered to someone else. Not asking for hospital transport if you can use other ways (e.g. a taxi)
  • Get your Flu jab, especially if you are contacted by your GP, as being in a higher risk group

Speaking on behalf of Rushcliffe CCG, Dr Stephen Shortt said: “No one should be unaware of the profound challenges that exist in our local NHS and care system, and in particular meeting everyone’s needs within the available resource. I’m not falsely upbeat, but there is real reason to be optimistic. All the organisations involved understand that these challenges cannot be solved by individuals or organisations on their own, but that we need to work together. That work is urgent and has already started.


“We have been working hard over recent months and have identified many, many opportunities to make better use of our collective skills and knowledge and improve the quality and value of care within the amount of money we have been allocated. There will inevitably be some tough decisions to be made as we progress these savings opportunities.”