Clinical Commissioning Group Placed Under Legal Directions by NHS England

NHS England has placed a clinical commissioning group under legal directions following an unprecedented £27 million overspend.

NHS England pointed to “serious performance, planning, financial and leadership weaknesses” at Coastal West Sussex CCG that have necessitated the decision.

The clinical commissioning group will now be required to conduct a governance review, a capacity and capability action plan, while also developing a recovery plan.

Coastal West Sussex CCG had been required to eliminate its financial deficit in the most recent fiscal period.

But the CCG suggested that the deterioration in its financial position had been due to “a number of factors, including increased demand for services, a challenging savings target, and investment in services including those to ensure patients received treatment within the national target of 18 weeks”.

The main provider for the group is Western Sussex Hospitals Foundation Trust, and this trust has been able to deliver one of the strongest financial performances anywhere within the NHS system.

Western Sussex Hospitals Foundation Trust reported a £12 million surplus in the nine months to December.

Defending its conduct, the clinical commissioning group indicated that its year-end outcome was forecast to be a £20 million overspend because £7 million of contingency funding will boost its position in the final accounts.

However, there is a further £10 billion of risk related to planning savings, and this will not be confirmed until the end of the calendar year.

Several clinical commissioning groups have been told by NHS England to maintain their official financial forecast, despite their actual real-world position having deteriorated significantly.

A paper due to be put before the CCG’s governing body next week illustrates the position at Coastal West Sussex CCG.

“From month six onwards NHS England required the CCG to report an unchanged forecast outturn position each month of a £0.25m surplus but to reflect a level of risk to achievement of this revised forecast. In December the CCG reported to the governing body that there was a risk of £19.4m to delivery of the £0.25m surplus”.

The paper also notes the action taken by NHS England.

“From month 10 onwards NHS England has asked the CCG to crystallise these risks into a reported deficit in line with other CCGs in a similar position nationally.”

Coastal West Sussex CCG is a clinically-led statutory NHS body, responsible for the planning and commissioning of healthcare services.

It is responsible for about 60% of the local NHS budget and commission local health services including mental health care, urgent and emergency care, elective hospital services, and community care.


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