Decision on which deckchairs to move delayed as healthcare in Cambridgeshire and Peterborough slowly sinks.

Earlier this week the Cambridge and Peterborough Clinical Commissioning Group (CCG) met to look at what funding it could cut to help it relieve its £192 Million deficit. This was of importance to local charities as they were looking at the funding for community services which includes a number of small grants that were to be ended or renegotiated. This blog concentrates charities but other community services that play a vital role are also under threat.

The first thing to say is that the groups affected have worked really hard with Support Cambridgeshire, and especially Julie Farrow from Hunts Forum to show the value of the work they do and to raise awareness of the impact of the cuts. This blog is simply CCVSs views which incorporate points raised by both Support Cambridgeshire and Healthwatch Cambridgeshire and Peterborough. You can read a statement from Healthwatch here.

The second thing to say is that the CCG are the second lowest funded per person in the country. This means that they get £350 per person less than West Norfolk CCG as an example. This is compounded by the speed at which the area’s population is growing. This is not new news, but it is relevant. What is also relevant is the fact that the CCG made a disastrous decision to contract out its older people’s healthcare and adult community services a number of years ago and lost a lot of money. It is probably also worth pointing out that this is not the first round of cuts for the sector from the CCG, I can still remember when many more projects were funded, including CCVS!

So what were the plans? I have highlighted the charity aspects from the papers which recommend

The Governing Body is asked to approve:

The outcome of the MDT process, Steering Group, COT and IPAC discussions is that we would cease funding or decommission the following:

  • Dial-a-Ride
  • The Stroke Association
  • The Alzheimer’s Society
  • The Carer’s Trust Cambridgeshire & Peterborough, Norfolk
  • The Health and Wellbeing Network
  • ECHIS (The Evelyn Community Head Injury Service)

The CCG would seek to renegotiate service provision and/or payment for the following:

  • The Care Network
  • Cambridge Hearing Help

The CCG would continue to fund:

  • The East Anglian Children’s Hospital

Just some initial thoughts.

The grant to Dial-a-ride is £6,516 a year or 0.003% of the deficit. The fact that this service is for Cambridge only and is not seen as clinical does not mean it is not saving the health service money. People can get ambulances, and in fact the CCG have a contract with the ambulance service. But dial-a-ride is so much more than just getting people to hospital, and is also I assume way cheaper per trip.

Cambridgeshire Hearing Help (CHH) work with 6500 users at 43 clinics across Cambridgeshire plus house bound provision to help them with hearing aids, they receive £34,682 or £5.34 per user. Specsavers receive £1,682,653 a year for their audiology service and charge £17 a session and people have to get to the shop. So, if these are to be renegotiated as per the papers lets hope loads more money goes to CHH. These figures do not even start to think about the value added of the CHH delivery model and the benefits of working with volunteers.

Why is the first main finding on the East Anglia Children’s Hospice (EACH) entry in the papers is “This service has great reputational impact on CCG if funding was ceased.” I think that the work EACH does is fantastic and needs to continue, and I hope that the proposal to continue to fund it was not because of the possible reputational impact and simply because EACH is fantastic!

So what’s the problem and what’s the solution?

There is undoubtedly a lack of money in the system and things need to be fairer. The local MPs are on the case

We should be putting pressure on whoever we can to get a fairer funding settlement, just as we are for education (what has Cambridgeshire done to upset the Whitehall mandarins to get such lousy settlements in education and health?)

Along with this we need to help the CCG understand the true value of funding the voluntary sector and the added value we bring. The savings that family carers make to the health system is massive, and so funding them to be better able to continue seems like a no brainer, but the CCG feel that the service supplied by Carers Trust is not cost effective as

“ this service provides services for carers rather than patients themselves and is more of prevention and crisis management rather than clinical provision.”

So if it prevents people accessing expensive services and helps the management of crises outside the system it should be welcomed. At an event I attended recently a Carers Trust volunteer and ex carer stated (and I paraphrase this)

“Carers Trust didn’t save my life, but they definitely saved my sanity and allowed me to continue to provide care for my partner”.

I know all the charities facing possible grant cuts would have similar stories, and I know that much work has gone on to ensure that these are shared with the CCG decision makers. At the end of the day they have to decide if it is making decisions based on just the basic figures, or if it recognises that prevention is always better than a cure.

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