Jan Thomas, the new Accountable Officer for Cambridgeshire and Peterborough Clinical Commissioning Group (CCG), came to our AGM last week to tell us about their plans for the future.
The CCG are responsible for planning and paying for most of our health care services locally. However, they are facing significant challenges with a deficit of £42.1 million pounds in 2017/18. Earlier this month, they were rated as inadequate by NHS England and are under their ‘Legal Directions’.
Jan told us that the CCG needs to do a ‘Much better job of catering for people’s individual needs. Everyone is different. We have to make it really easy to access and use services. We have to get best use of the money. And we should be using technology appropriately.’
Jan says that, as Accountable Office, she is ultimately accountable for the £1.2 billion health allocation for local people.
What went wrong in 2017 -18
Some of the problems with the deficit in 2017/18 happened because of the system used to buy care for local people.
Jan told us that, ‘As a commissioner, we were paying the hospitals on what was a “pay as you go” system. The hospitals need to see people to get paid and we need to try to reduce the number of people going. That isn’t the way we should be managing health care.’
‘Last year, we overspent as the hospitals were seeing lots of patients. Most of the time they were too full to cope with them. What we have done this year with the hospitals is say “Can we agree how much you need to run your organisation?” The reason this is important is not about the money. The reason this is important is that it has freed staff who focus on the future where we can think differently.’
‘The second thing that happened was to do with continuing health care, this is how we provide health care for the most vulnerable people in our community. As a CCG, the process and the way we were dealing with that wasn’t good enough. People were waiting a long time and there was confusion about different organisations’ responsibilities. This wasn’t about the people we had employed, but what we were enabling them to do.’
‘The third thing that happened was around prescribing medicines and changes that were happening nationally.’
Plans for the future
Jan told us that ‘My job is to change the conversation. I would like to provide the same thing for everybody, but we really can not do that. We are going to have to make some choices. We are not going to make the choices about cutting and shutting services, just to save some money. But we might need to make some choices like “Where do people go for those services, and how can we afford all of this infrastructure?”
‘We will do what we’ve got to do today to get through this financial year, because we have to. We need to come in on the money this year to have the freedom to do this.’
‘If we don’t come in on the money, all sorts of different people will come in, regulators will come in and try and give us some support to come out with a different answer. I would rather that the answers came from our patients, from our staff, from our key experts.’
‘We are going to make mistakes, and when we do I am asking you to assume that it is not deliberate. We hold our hands up if we do this. If at any point you don’t think we are doing that, please raise it with Healthwatch colleagues. Already I’m hoping we are changing the tone in that honesty and transparency.’
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