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NHS bosses warn of £270 million cuts over next four years in Derbyshire

NHS leadership in Derbyshire fear staff “will struggle” as a result of multi-million cutbacks and a merger of the county’s four main health organisations.

At a meeting of the four Derbyshire Clinical Commissioning Groups last week, members of the governing bodies signed off on plans to make nearly £270 million in cuts over the next four years.

As a result, the CCGs suggested that cutbacks may be required to hip and knee replacements, cancer care and treatment for respiratory illnesses.

Over the course of the current financial year, which ends in April, the CCGs have had to make cutbacks of £51 million, due to a crippling deficit of £95 million.

The remaining £44 million will be effectively written off using a pot of money for struggling NHS organisations – the Commissioner Sustainability Fund (CSF).

However, the CCGs must also now make savings of £69.5 million during 2019 into 2020, followed by £76.5 million, £66.4 million and £56.1 million respectively in the years after.

From April 1, the four CCGs are set to merge into one organisation as a means of achieving the sufficient scale to make the financial cutbacks required and to raise standards.

The merger is now in the final stages and awaiting sign-off by Matthew Swindells, NHS England’s national director for operations and information.

Ian Gibbard, a governing body member from North Derbyshire CCG, said: “What we all need to be thinking about is the impact of this on the workforce.

“There are huge changes and savings being made, and I think that staff at our providers, certainly, will still struggle.

“We need to be aware of these risks and to keep working with the workforce through this.”

Chief executive of the CCGs, Dr Chris Clayton, said that he was “cognisant” of the challenges facing the workforce.

He said: “Finances and workforce are among the biggest challenges we are facing.”

Dr Avi Bhatia, chairman of Erewash CCG and soon to be the chair of the combined CCGs, said: “It is not just about the quantity of workforce but also the ability of the workforce to alter their roles.

“We need a bit more flex to help our workforce to work differently.”

Jill Dentith, a member of Hardwick CCG, said: “The executive are working really hard with staff to finish the process of engagement.

“Certainly, as we are moving forward, we need to continue to be working with staff, and how they can work with us in the future.”

Sandy Hogg, executive director of turnaround for the four CCGs, said: “Merging from four to one organisation we are able to make big efficiencies, including of our estate (buildings) and our people.

“Particularly due to the size of Derbyshire and the amount of travel involved for staff – we will be able to allow more agile working.”

Meanwhile, Dr Ben Milton, chairman of North Derbyshire CCG, said regarding cutbacks: “We have made significant efficiencies over the last few months, but we can’t be complacent about this, the amount of savings required is still extremely significant.”

Ms Hogg stressed that it was important that the CCGs maximised the amount of savings which can be made and that resources are used in the best possible way.

This includes best practice for prescribing medicine – with £16 million in savings possible in this area.

After the meeting, Helen Dillistone, executive director for corporate strategy and delivery said: “Staff are our greatest resource and key to making sure Derbyshire patients get high quality, coordinated and efficient NHS services across the county.

“The merger of four CCGs into one has been a big piece of work, and staff at all levels have worked together to make this ambition happen – with our completion date just a month away.

“Some teams have merged into one to cover the whole county CCG area and staff across Derbyshire have increasingly worked jointly as we organise and streamline functions and reduce any duplication.

“There has been more flexible working, from alternative bases, we’re making greater use of telephone and video conferences, with the priority always being to work in the best and most efficient way.

“We’ve worked closely with our staff and included them in the decision-making process to do this and we’re very grateful for their continuing hard work.

“By pulling together in this way we’re all working towards our goal to improve efficiency and the way we work for both patients and staff.”

Linda Garnett, workforce and organisational development lead for joined-up care Derbyshire, said: “The skills and workforce mix of local authority and NHS colleagues is being closely monitored so we can offer the right opportunities and support to make sure staff and services have what they need to offer the best care to patients now and in future.”

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