Agenda item

The Chief Executive from NHS North Yorkshire and York will be in attendance at the meeting to present the next phase of the North Yorkshire and York Clinical Services Review. Also in attendance to join the debate will be representatives from York Teaching Hospital NHS Foundation Trust and the Vale of York Clinical Commissioning Group.

The Chief Executive of NHS North Yorkshire and York presented a series of papers related to the North Yorkshire and York Clinical Services Review Report.

In his presentation to Members, the Chief Executive of NHS North Yorkshire and York clarified that the report had not been written by KPMG, but that they had supported work on its production. He informed the Committee that it was intended that the report would become a working document for Clinical Commissioning Groups (CCGs) to use within their communities.

Discussion then ensued around the financial situation that CCGs would inherit.  Members were informed that NHS North Yorkshire and York had a projected £19 million deficit at the beginning of the current financial year, however this had been currently reduced to £12 million and it was hoped that it would be lower by the end of the financial year.

It was reported that the NHS Commissioning Board would take responsibility for a third of this deficit leaving the outstanding amount to be split on a pro-rata basis amongst the 4 CCGs across the region.

In addition there was an ongoing efficiency requirement across all of the NHS. Locally there was a challenge to make approximately £55 million savings across all health organisations in the region. The hospitals would have responsibility for just over half of this with the rest falling to the commissioners.

In response to a question from a Member about what ideas KPMG had proposed, the Chief Executive at NHS North Yorkshire and York  responded that KPMG offered analytical skills and gave NHS North Yorkshire and York and the CCGs the chance to consider how other models could be applied as the scale of the financial challenges made change inevitable. He also felt that KPMG’s involvement in the review had challenged the health community to look at changes that had to be made in order to bring down the deficit.

The Chief Clinical Officer at the Vale of York Clinical Commissioning Group, informed the Committee that the intention was that in a year’s time the CCG would be operating with a balanced budget, but he did not want anyone to underestimate the significant challenges.

The Lay Chair of the Vale of York Clinical Commissioning Group warned Members that as the CCG pushed against its allocated budget, the hospitals within the region could go into deficit. He felt that the report disguised the challenge, that as providers of community care services, the hospitals could potentially be worse off financially than the commissioners in the future.

Some Members felt that the pro-rata deficit the individual CCGs would take on from NHS North Yorkshire and York did not take into account the differing needs, catchment areas and specialisms of hospitals across their different areas.

The Chair asked if NHS North Yorkshire and York had passed over £3 million of funding to the Council for Health, Social Care, Reablement services and other issues. She asked for confirmation whether this would be paid by the 31^st March and what might happen to this money if the NHS North Yorkshire and York were abolished before the funds were transferred.

In response to the Chair’s question, the Chief Executive at NHS North Yorkshire and York stated that the Director of Finance would deal with this as soon as possible and that some of the monies would be passed straight over to CYC, however other parts were discretionary.

Some Members queried how the review had involved service users and residents and what consultation had been had with them. The Chief Executive at NHS North Yorkshire and York responded that it was critical that they had the evidence to back up any proposals they put forward.  The Chair said that a significant social mix of users had adopted a co-production model of working and it was acknowledged that this worked, she hoped that the CCG would follow suit and they confirmed that this was their intention. The Chief Executive from York Hospital said that there was often no time in the current financial climate to undertake lengthy consultation.

There was a need to work urgently and at a certain pace but this did not mean it would not be on a collective basis.

Some Members had significant concerns around the non-equitable share of the debt between CCGs in the region and therefore proposed a motion that a letter be written to the Secretary of State for Health requesting that he write off the debt and also that the two MPs for the York area be invited to a future meeting to discuss what they had previously done to alleviate this situation and what could potentially be done in the future. The motion was seconded and when put to the vote this motion was carried.

RESOLVED:       (i)      That the papers be noted.

(ii)      That a letter be written to the Secretary of State requesting that the outgoing North Yorkshire and York Primary Care Trust’s existing debts be written off.¹

(iii)     That the two Members of Parliament for the City of York area be invited to attend a future meeting of the Committee.²

REASON:           To keep Members informed of the actions taken as a result of the proposals suggested in the North Yorkshire and York Clinical Services Review report.