SAVINGS PROPOSALS 2012/13 CITY & HACKNEY CCG

CONTEXT This report provides information to the Shadow Health & Wellbeing Board on proposed savings in 2012/13 against the commissioning budgets delegated to the CCG The CCGs plan was to consider a 3% saving across all budgets (both delegated and those held by NHS ELC) as this would cover the financial gap for 12/13 For spend in the acute (hospital) sector CSS provided benchmarked information on where efficiencies could be achieved All savings proposals have been put through a “clinical challenge” process for CCG clinical leads to discuss the assumptions and impact, and through a financial challenge – CSS Director of Finance has been asked to assess all plans and assure CCG on their deliverability All plans have been discussed at the CCG Committee Total savings proposed are £9m

ACUTE CARE The main savings will be subject to contract negotiations but are aimed at commissioning “best practice” Reducing out patient followups (£2.6m) CCG audits have been undertaken to understand the implications Impact at all Trusts – BLT has biggest potential to reduce activity Reducing new GP referrals (£130k) Continuing CCG work on implementing new pathways Implementing new contractual arrangements for some services (£770k) Reductions in attendances at A&E as a result of 111/new out of hours model (£500k) Reductions in activity if walk in centres close (£650k) Transfer of dental activity from Homerton to community (£200k) Reduction in spend by practices (£90k)

Cost improvement programme on Community Health services provided by Homerton Part of transfer agreement (£1.2m) Reduction in obstetric non delivery short stay admissions (£75k – subject to audit on potential to shift to primary care) Reduction in double payments to Homerton maternity services (£500k) Reduction in spend on GP prescribing (£945k)

MENTAL HEALTH SERVICES Reduction in psychological therapy and Life Skills service at ELFT (£1m) Reduction in voluntary sector contracts (£200k) Reduction in spend on out of area contracts (£200k)

INVESTMENTS A range of new investments have been proposed as part of this exercise We also expect Trusts to put forward some investment ideas Undertake an initial assessment of investment proposals Further discussion about the proposals at the February HWBB