Team now in place to tackle Shropshire health body's financial woes

A new team has been appointed to manage Shropshire and Telford Clinical Commissioning Groups, which are involved in the decision on the future of the county's A&E departments.

David Evans, current accountable officer of Telford & Wrekin and Shropshire CCG, said the team and plans are now in place to address Shropshire CCG's financial problems.

NHS England issued "directions" to Shropshire CCG in April, effectively meaning it will be keeping a close eye on its financial performance

Shropshire CCG was placed in special measures when it revealed it had an in-year deficit of £14.5 million. As part of the special measures plan, a new turnaround director has been appointed, an improvement plan is in place, and a financial recovery plan has been drawn up to tackle the overspend.

However Mr Evans said it will take more than a year to sort Shropshire CCG's finances out.

He said: "I have always been very clear in terms of the financially recovery for Shropshire CCG you won't achieve that in one year. Realistically it is three years to get it back into balance.

"We are continuing to do some work to understand what's happened and learn some lessons from that.

"I am broadly confident we have got a plan now for this year and beginning to start the next two years' plans to get us back into financial balance.

"This is about making sure that you have a team in place to make sure they will work across the two CCGs – it is not about one individual.

"We have had a restructure of the executive team and that is just starting now. It is a joint executive team across both CCGs. One of the things that was said to me at the start was how will you find the capacity to do two jobs, but actually when you look at the number of meetings people were going to that had people on from both CCG's, it was a lot. A joint management team means you are not duplicating people going to meetings.

"This has been a very difficult time for Shropshire CCG and I think what they are welcoming at the moment is some stability.

"We are beginning to look at where we can make changes to the way things are delivered that doesn't impact adversely on patients but does help with money. For example we are having discussions about – can we use community beds in a different way to prevent people from going into the acute sector?

"We are starting to look at the two CCGs working closer together on specific projects and with community projects."

Mr Evans said both Shropshire and Telford CCGs are currently looking at different ways to run services to benefit patients and finances. He added: "We are currently looking at the way outpatient appointments are managed – particularly follow-ups.

"Instead of someone having to go for a follow-up they could get seen either locally or they may not need to get seen at all – we may have an urgent contact number to get advice instead. It is about how clinicians in the hospitals support the primary care service. The resource might not be money – it might be people."

Mr Evans is also leading the Future Fit review of the county's health care, which will decide on the possible closure of one of Shropshire's two A&E units.

The Shropshire group's members voted not to back the Future Fit strategic outline case – which sets out the framework for the services which will be based at either Royal Shrewsbury Hospital or Telford's Princess Royal. But the Telford group voted to support the strategic outline case.

Mr Evans said the hospital could go forward with the plans for Future Fit without the CCG's backing – but said he was against that idea.

He said: "The hospital could decide that for clinical safety concerns they could make emergency clinical decisions. I don't think that would be the right avenue to go down personally but that would be based on the clinical risk at that time. If it was that high there would be no alternative.

"Nobody is saying the notion of one critical care centre and one emergency centre is wrong. The only issue is around the confidence around the adequate resourcing around that shift in activity."