Bedfordshire Clinical Commissioning Group on course for “real terms deficit”


Health bosses in Bedfordshire want to put the brakes on expenditure to avoid implementing a so-called “stink list” of cost cutting measures.

Early indications in the current financial year suggest Bedfordshire Clinical Commissioning Group (CCG) is on course for a “real terms deficit”, which it wants to avoid at all cost.

“A considerable amount of estimation” is in the current figures, its joint chief finance officer Chris Ford told a CCG meeting.

“The reporting position is a surplus in operational terms, that is to say our expenditure is lower than our income by £340,000,” he said.

“Unfortunately, to deliver the surplus target we required, we should have had a much bigger surplus than that, up to £1.850m.

“So we are £1.5m behind with our surplus plan, as of month two. That is driven by non-elective activity and the cost relating to that.

“We are still at this stage forecasting delivery of our plan.”

An estimate from Bedford Hospital “was £1.5m below what they actually invoiced us for in the period up to month two” he explained.

“So the position has significantly deteriorated as a result of that.”

Information around “activity across the system is also indicating there is significant financial pressure”, according to Mr Ford.

“We are seeing a year-on-year increase in activity which is now going beyond double figures,” he warned.

“The numbers are around 12 per cent year-on-year increase. Clearly that is well above any funding settlement we would have.

“So we’re working very hard to understand what’s driving that level of increase, and to come up with anything we can think of to put the brakes on expenditure.

“Obviously I have a major concern about this position. It’s far too early to do an kind of accurate forecast at this stage.

“But, if this level of expenditure was continuing, it would seriously undermine our capacity to deliver our control total and could actually send us into real terms deficit, which would be a very bad position to be in.

“We have reported it to our regulators and are going through a series of meetings with them.

“We’re not panicking,” he added. “We’re just trying to understand it.

“It does call into question our capacity to fully deliver the surplus that we require to repay the underlying debt the CCG owes.

“My primary concern is that we do not go into real terms deficit because that would be very unfortunate for the CCG in terms of our capacity to govern ourselves.

“Our regulators would take a dim view. I am hopeful we won’t be into that position, and I’m still aiming to deliver the plan in full.

“There’s a significant amount of money we can claw back. It’s by far the worst thing we would want to do. We’ve already given it the nickname of the stink list. Nobody wants to do it.

“Patient safety is absolutely key. So we wouldn’t do anything which would endanger individuals.”

Chief operating officer Mike Thompson said: “It’s probably a number of things and we’ve not got the answers yet.

“But we know where to look, we’ve got the ability to analyse that and we’re doing it as matter of extreme urgency.

“We’ve created more supply. But we may have stimulated more demand.”

Words: Euan Duncan, Local Democracy Reporter

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