NHS in North West London prepares for financial recovery

The NHS in North West London is developing a financial recovery plan, which covers the whole health and care system across our eight boroughs.

NHS North West London CCGs face a significant deficit in 2019/20 – and our position looks as if it will continue to get worse unless we act now. To address this deficit we are developing a financial recovery plan. This plan will not be a single document; instead, it is likely to be a set of proposals, with a number of possible options set out.

Some of these ideas will be about removing waste and duplication and will not affect patient services.  Some ideas, especially those affecting patients, will generate strong views, and we will need to engage with patients and partners carefully.

In putting forward our plans, we want to emphasise again that the safety of our patients and the quality of our services will always come first. We will work with patients, local residents, NHS staff, our local authority partners, Healthwatch and the voluntary sector as our plans for the next five years take shape.

We would also want to emphasise that we have no wish to inappropriately shift costs to other parts of the system, and we want to work with all partners in the best interests of our residents.

Our plan aims to make sure that our services are clinically and financially robust. There are four key elements of our plan:

• Eliminating waste and duplication, and making sure we consistently get the best value for taxpayers’ money
• Stemming further growth in demand for services by doing things differently
• Standardising clinical services to make them more efficient and rationalising non-clinical (back office) functions
• Working as one integrated system: we are developing an ‘integrated care system’ across North West London in which providers and commissioners will work as a single team with our local councils to deliver the best care and outcomes for our patients and residents.

We have already begun to propose some immediate measures to avoid unnecessary waste.

These include looking at ways we can be more efficient in the following areas:

Elective hospital services 

By bringing some elective hospital services back to local North West London providers, there is evidence that we could save 30% on tariff costs.

Outpatient services

Some patients are being offered unnecessary outpatient appointments in cases where there are better options available to be explored instead.

Over the counter medicine prescriptions

The current cost of prescriptions for over the counter medicines is £18m a year, so we are looking at ways to safely reduce this spend.

Patient transport

There are opportunities to bring down patient transport costs by standardising assessments.

Home oxygen

Evidence suggests that some oxygen costs can be brought down without loss of service.

Enteral feeds

There is evidence that we could reduce the costs around enteral feeds without any reduction in quality.

Unscheduled care

Unscheduled care has seen the biggest increase in activity and it the major driver of costs, so we need to consider if there are ways we can safely make savings in this area.

Demand management

CCGs will continue to meet with GP practices and discuss expectations around contract usage and activity.

We will be talking to patients, local authorities, local residents and other stakeholders about plans that will affect services for the next few years, as they take shape. Some elements of our plan may require specific public engagement plans and we will work with patients, the public and all our stakeholders to get their input to build consensus around the best ways forward. As further proposals emerge from our financial recovery plan we will keep you fully involved and informed. 

A copy of the letter this text is taken from can be found here.

ENDS