Government reforms put clinical commissioning groups (CCGs), which are led by GPs, in charge of planning and buying healthcare from 2013, but all three organisations covering West Sussex are in special measures in part due to financial deficits.
The three CCGs are part of a new regional NHS initiative called clinically effective commissioning, which looks to standardise policies for when patients should undergo certain treatments and procedures.
According to a recent West Sussex Health and Social Care Committee (HASC) report, the aim of the project is to make sure commissioning decisions across the region are consistent, reflect best clinical practice, and represent the most sensible use of resources.
But last Friday James Walsh, vice-chairman of the HASC, asked: “What exactly is being proposed? Is this some form of rationing or delaying treatment?”
He explained that rather than dealing with statistics, they were talking about patients who had problems, many of which interfere with their daily lives.
Geraldine Hoban, accountable officer for the Horsham & Mid Sussex CCG and the Crawley CCG, explained the changes were bringing in more consistent thresholds for treatment.
She said: “We are not doing this for arbitrary reasons or to save money. This is based on up to date clinical evidence.”
She added: “This is about people having procedures which we do not believe adds the clinical value they need.
“It’s not rationing, it’s about adhering to the clinical evidence.”
She went on to outline the ‘significant financial challenge’ facing the healthcare system in West Sussex, and how these changes were taking place before ‘we starting making some difficult decisions about difficult services’.
They also found that previously some procedures had no formal policy, while in others such as orthopaedics activity the area was a significant outlier.
Other revisions were required were policies did not improve outcomes or patient experience.
So far the clinically effective commissioning programme is split into three tranches. The first two have been reviewed by all the CCGs and updated where necessary in line with National Institute for Health and Care Excellence guidance.