NHS bosses in bid to save £6.4m by cutting services

Breast implants, paracetamol, IVF, obesity treatment and free   suncream are on the cull hitlist
Breast implants, paracetamol, IVF, obesity treatment and free suncream are on the cull hitlist

GPs in Blackpool are facing a crackdown on the number of patients they refer for minor operations in a bid to save money.

Health bosses plan to strictly enforce guidelines for procedures it classes as of ‘low clinical value’, including grommets — a type of surgical hearing aid — for children under the age of 12.

Others include cosmetic surgery, such as breast implants or tattoo removal, bariatric operations for obese patients, caesarean sections, and assisted conception procedures such as IVF.

Doctors in the resort could also be told not to prescribe paracetamol, cough and cold medicines, or suncream, unless there is a longer-term clinical need.

The town’s clinical commission group (CCG), which organises and pays for residents’ healthcare and is based in a stand at Bloomfield Road, is proposing drastic action after its financial control was found lacking during a recent inspection.

It said it needs to save £6.4m because it simply can’t afford to keep paying for the number of procedures currently being carried out.

The minor ailments scheme at resort pharmacies, which sees children’s medicine doled out for free, could also be reviewed.

The CCG’s chief clinical officer, Dr Amanda Doyle, said: “There is no endless pot of money and the current situation is not sustainable.

“We have a responsibility to make the best use of the resources available to us and ensure public money is spent wisely within the local healthcare system.

“We have to ‘live within our means’ and we need the public’s help to do that.

“We have plans to address this financial challenge whilst still providing services of the highest quality but to do this we are going to have to make difficult decisions in order to make best use of the money available to us.”

She continued: “The number of people being referred by their GP for hospital procedures or operations has increased year-on-year, and is now well beyond what we can actually afford.

“We need to make sure that the policies and procedures we have in place for when people should and shouldn’t be referred by their GP are followed to the rule.

“We also need people to be more realistic with what they request on prescription from their GP.

“Low priority items such as cough and cold remedies, paracetamol and sun creams to name a few, are all readily available over the counter in supermarkets and local pharmacies.

“But, we actually spend around £800,000 of our budget paying for prescriptions of these items each year.”

Medical procedures affected by its proposal also include body contouring (surgery after significant weight loss), carpal tunnel syndrome, circumcision, complementary and alternative therapies, face lift, hysterectomy, knee joint, laser eye surgery, ear pinning, reversal of sterilisation, nose jobs, skin lesions, spinal corn simulations, tonsillectomy, and trigger finger ops.

“During 2015/16, a total of 3,788 procedures of limited clinical value (POLCV) were undertaken at a cost of £2.94m,” CCG documents read.

“Not all of these could be inappropriate but a proportion would.

“The introduction of clinical triage process will help ensure the policies are applied appropriately and consistently for all patients.

“A further range of POLCV are being developed on a Lancashire-wide basis which will be released in September covering: Lumbar spine procedures, other stomach operations, bariatric surgery, insulin pumps, caesarean section, hip arthroscopy, treatment of varicose veins, function electric stimulation (FES) for drop foot.

“It is proposed these are adopted as soon as possible by Blackpool CCG.”

The group is currently consulting, via a questionnaire on its website, on the medicines GPs will be ordered not to prescribe.

As well as cough and cold medicines, suncream, and paracetamol, the list contains dry skin preparations, bath and shower products, nasal sprays, wart and verruca treatments, products for oral hygiene and mouth ulcers, vitamins, and supplements.

It also includes probiotics, topical fungal nail paints, antiperspirants, barrie creams, antihistamines for hayfever, pain relief skin rubs, homeopathic remedies, and haemorrhoid preparations.

Supermarkets often charge less than 50p for a packet of paracetamol, but it costs the NHS £10.31 after administration fees.

South Shore MP Gordon Marsden said: “The CCG appears to have produced a long, mixed bag of potential savings by GPs.

“Some of them are particularly relating to minor ailments and I think most people, given the pressures they are under, would understand; others, particularly laser eye surgery, knee procedures, and lesions, most people think are an important requirement of the NHS.

“We really need to have a much more thorough listing of procedures by the CCG.

“Dr Doyle says they have to live within their means. People will expect the CCG to be much clearer about their priorities, and also to be looking at their own administration costs.”

Blackpool North and Cleveleys MP Paul Maynard said: “I do think that it is right that the CCG reviews how it spends public money and the policies around prescriptions and procedures. When you can buy in supermarkets some tablets like paracetamol for as little as 19p, yet a prescription with on-costs adds up to over £10 it makes sense.

“I would be worried though, if the review around the guidelines of certain types of surgery prevented those who are in genuine medical need of the procedure to be denied it.

“I would encourage anyone with views of these proposals to engage fully with the consultation.”