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12 November 2010, 17:29 | Updated: 12 November 2010, 17:33
Surrey NHS has announced massive changes to the treatments it will fund; promising to safeguard vital services. This is the statement issued by the trust on Friday
Fundamental changes that start to secure Surrey's NHS for the future have been approved today by the Board of NHS Surrey.
Anne Walker, NHS Surrey Chief Executive, said:
"The NHS in Surrey started 2010/11 needing to make savings of over £125 million. Whilst we have made steady progress and delivered significant savings through a range of schemes, additional cost pressures have been incured during the year. As a result, our latest forecast is that unless urgent action is taken we will end the year with a deficit - overspend - of over £35 million which is clearly unacceptable."
"Our vision is simple - to make the system work better for patients. The changes we support will see the most vital services safeguarded, patients with the greatest health needs prioritised and clinical evidence behind every decision. They will mean improving quality while reducing costs. Today's decisions will make it easier for patients to get the right care, from the right professional, in the right place, at the right time."
Today the Board acted to make more savings this year by ensuring that decisions about treatment are based on patients' healthcare needs.
Changes agreed by the Board include:
* Fast, Steady, Stop - We need to ensure that in future referrals are clinically appropriate and procedures are clinically effective. So we're adopting a "Fast, steady, stop" priority system.
* Fitness for surgery is very important for patients to get the most benefit from treatment. We are talking with GP commissioners about the principle of deferring planned care for smokers so that they can complete a stop smoking course beforehand.
* IVF treatment - We will not be funding new referrals for assisted conception (In Vitro Fertilisation or IVF) starting from December 2010, although treatment that has already started will continue. Patients who are nearing 39 years and meet the clinical criteria will be considered. Assisted conception guidelines will be reviewed again in November 2011.
* Being treated appropriately and in turn - pre-approval will be required for all routine surgery. Patients will be prioritised according to clinical need and in line with the 18 week standard for waiting times. By slowing down some non urgent procedures over the next few months, NHS Surrey will be able to continue to fund other urgent care.
* Reducing unnecessary hospital admissions - Currently patients are sometimes admitted to hospital while a decision about their treatment is still being made. Figures show that up to a quarter of people admitted through A&E don't need to be. In future the principle for hospital admission will be 'deciding to admit not admitting to decide'. This means that clinicians will not admit patients to hospital unless they decide it is necessary.
* Enhanced community hospital hubs - the Board also approved work on proposals that could see patients able to get far more services from a number of "enhanced" community hospitals. The current number of community hospitals in Surrey means vital services are stretched thin; the ideas may mean expanded services but from fewer locations. The enhanced hospitals could provide 24/7 consultant-led inpatient care, rapid assessment and point of care diagnostics. They could also provide an urgent care access point (in addition to A&E and GP urgent care), able to receive ambulances. This would mean a far greater range of people benefiting from services at their local community hospital. Early thinking proposes offering expanded services from our hospitals in Woking, Caterham Dene, Farnham and Haslemere. We need a good dialogue to now work up these ideas into firm plans. Milford hospital is a centre for specialist rehabilitation, currently undergoing a £1.5m refurbishment, and will continue to provide these specialist services.
NHS Surrey itself has tough targets to save money. Over the next three years, management costs will reduce from £17.3 million last year to £9.8 million by 2012/13.
Anne Walker continued:
"We must take the necessary steps to ensure we live within our means, it's that simple. The choices we have to make to do so are not so simple and the Board has made some tough decisions because we cannot continue to do everything we currently do - or to do things as we have always done them.
"We've looked long and hard at everything we do and made our decisions based on clinical evidence. We're putting the foundations in place for a system that meets patient needs and makes sure precious resources don't get used in any other way."
"The proposals to establish four enhanced community hospitals are at an early stage and we will be consulting widely about them before any decisions are made. They represent an exciting opportunity to redefine the role of these community hospitals, ensuring they are there for every member of the community they serve and expanding their role to meet a wider range of healthcare needs."