Health bosses in mid and south Cheshire are set to cut more than £20 million from their budgets while transforming care in the community.
NHS Vale Royal clinical commissioning group (CCG), the body which buys healthcare for Northwich and Winsford, is set to make efficiencies worth £10.5 million by March 31, 2020.
Meanwhile, NHS South Cheshire CCG – which covers Crewe, Nantwich, Middlewich, Sandbach and Alsager – is aiming to cut £11 million from its budget by the same time.
It comes as demand for services increases each year as doctors face the challenge of caring for an ageing population – while the NHS is also shifting its focus towards prevention to help keep the nation healthier, avoiding more costly treatment in the long run.
“If you do what you have always done you will get what you have always got,” said Dr Jonathan Griffiths, chairman of NHS Vale Royal CCG and GP at Swanlow Medical Centre, in Winsford.
“There is an increasing demand and that is partly because the NHS has been successful. People are living longer with chronic conditions, which is fantastic news.
“Twenty-five years ago if you had a heart attack, your chances of survival were much less than they are now. Those people are surviving now and living for longer which is great, but they require medication from their GP, and it is creating an ongoing demand.
“We need to do things differently. We cannot continue to manage this increasing demand with the resources we have got. It has to be done in a different way.”
The savings are part of the NHS quality, innovation, productivity and prevention (QIPP) challenge, which pushes NHS organisations to be more efficient.
The two CCGs – which share the same governing body – have so far identified where £9 million of the savings can be found, with the remaining £12.5 million to be found over 2019-20.
But Dr Griffiths insists that the drive for efficiency will not come at a cost to the quality of care patients receive.
“We must not forget that the first word of QIPP is ‘quality’,” he said.
“Often the care that is better quality is not necessarily more expensive – often quality care is more efficient care.
“If you can put in a system whereby someone is seen once rather than multiple times and it is better quality, then it will be more efficient.”
The biggest saving so far identified for 2019-20 involves making GP prescribing more efficient – with a £1.7 million saving across the two CCGs.
Prescriptions are constantly under review by GPs – with patients often put onto cheaper medication as more advanced drugs become available.
And Dr Griffiths insists that the safety of patients is always the top priority – with any planned savings having to undergo both a quality impact assessment and an equality impact assessment to make sure patients are not put at risk by the changes.
He said: “We are constantly changing things all the time to be more efficient, without affecting patient care. Patients are at the heart of everything that we do.
“People do get worried that we are making efficiency savings or changing medication, but you have to remember that we are not about doing things to cause harm to patients.”
The wheels are in motion for the two CCGs to merge with East Cheshire CCG and West Cheshire CCG next year, subject to approval from doctors.
It is hoped the merger will help to make commissioning more efficient across the county.
That will free up cash to be spent on community care, which will be overseen by the Central Cheshire integrated care partnership – made up of Mid Cheshire Hospitals NHS Trust, mental health care provider Cheshire and Wirral Partnership and the local GP Alliance.
NHS bodies are also trying to work closer with Cheshire East and Cheshire West and Chester councils on social care in a drive for further efficiency and improved quality of care.
“I think it is going to be fairly challenging,” added Lynda Risk, chief finance officer at NHS Vale Royal and South Cheshire CCGs.
“We are going to be working together more across Cheshire and with the local authorities to get transformation in terms of getting greater efficiency.
“It is more about transforming the way we treat people.”