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NHS Consults on Restricting Services

ne-essex-ccgClinicians want to hear local views on plans to restrict services

Clinicians at North East Essex CCG are seeking local people’s views on their plans to restrict IVF services in the future – and they are inviting everyone to give their feedback.  Under the plans, they are proposing restrictions to the current IVF service as it does not provide sufficient benefit to the overall health economy.

Certain groups of patients would still be able to access IVF: for instance, those patients who are undergoing medical treatment that would leave them infertile.

They also propose that couples experiencing difficulties in conceiving could still seek medical advice through their GP in the first instance.

Dr Hasan Chowhan, Clinical Director at the North East Essex CCG, said:

We recognise that infertility is a very difficult issue for those affected by it and we have not taken this proposal lightly or without engagement with other clinical professionals.  We fully intend to review this decision in the near future.

Between 2013/14, the CCG paid for 107 fertility procedures which amounted to £386k – the equivalent of:

  • 25 drug treatment courses available for breast cancer;
  • 15 community nurses;
  • 104 hip replacements;
  • 108 patients being admitted to an acute stroke unit at Colchester General Hospital.

Samantha Hepplewhite, Acting Chief Officer at the North East Essex CCG, said:

We have managed to achieve around £35m savings over recent years.  However this challenge will continue as we need to find a further £14m savings each year for the next four years.

We have a requirement to stay within budget and if we do not implement these decisions and further proposals then we would have to select other services to restrict.  Current local demands for healthcare services are costing more money than is currently available.

In addition, the CCG is also intending to restrict the following services:

  • Any Qualified Provider – Spinal Service – The CCG would control activity and expenditure for manual therapy and spinal services, ahead of these services moving to the lead provider arrangement in April 2016.
  • Clinical Priorities Policy – The purpose of this policy is to provide a mechanism for deciding whether referral of an individual patient for a specific assessment and treatment should be funded, based on clinical effectiveness. We are reviewing this policy to bring it in line with other NHS commissioners.
  • Continuing Healthcare – We believe that new patients requiring NHS continuing healthcare care at home, should be entitled to up to 10% above what it would cost for the same care in a residential or nursing home setting.
  • Gluten free – The CCG is restricting the prescribing of gluten free foods to young people, pregnant women and breastfeeding mothers and stopping prescribing these products altogether to all other adults.  These products are now available in shops and there is a variety of alternatives widely available.
  • Threshold for elective procedures – All patients being referred for non-urgent elective surgery and who are smokers should be referred to smoking cessation services at the initial referral/assessment/appointment.  Meanwhile, overweight and obese patients should be strongly encouraged to lose weight before their operation.  Failure to attend smoking cessation or weight loss programmes may have an impact on whether individuals could undergo their procedure.
  • Vasectomy and female sterilisation – The community vasectomy and female sterilisation services are being reviewed by the CCG as these services have no or limited clinical value – rather they are considered as one of many forms of contraception.  Both vasectomy and female sterilisation will however be available in cases of complex health needs.

Please see our consultation document with further details at www.neessexccg.nhs.uk

The CCG is holding a number of engagement events over the coming weeks aimed allowing local people to find out more about its plans.

DateVenue
Friday 26 June (3pm)Clacton – Sam’s Hall, CVST, Rosemary Road, Clacton CO15 1NZ
Tuesday 7 July (6pm)Colchester – Room 12a, Primary Care Centre, Turner Road, Colchester CO4 5JR
Friday 10 July (2pm)Clacton – Princes Theatre, Town Hall, Station Road, Clacton CO15 1SE
Thursday 16 July (6.30pm)Clacton – Princes Theatre, Town Hall, Station Road, Clacton CO15 1SE

Please email to confirm your attendance at any of the above events –

NEECCG.enquiries@nhs.net

The closing date for feedback on our IVF proposal is Monday 7 September 2015.  If you have any feedback in relation to these changes, please email your comments to NEECCG.enquiries@nhs.net or write to PALS, North East Essex CCG, Primary Care Centre, Turner Road, Colchester CO4 5JR.

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Local Health Forums

The Health Forum

The NEE Health Forum is a largely enthusiastic and committed body of people who are interested in health matters.  They are all people who have registered as public members of North East Essex Clinical Commissioning Group.

The Health Forum is not formally part of the Clinical Commissioning Group, but members of the Health Forum Committee are invited to be part of all decision-making meetings within the CCG so that they can obtain and reflect the views of people from North East Essex to the group in a timely way.  The Clinical Commissioning Group wants the Health Forum to be as inclusive as possible, and so the criteria for eligibility are very broad.  There is more detail on the Join the Health Forum page of their website.

Members of the Health Forum are able to vote for the Health Forum Committee.  The Health Forum Committee has a number of sub-groups which are looking at specific health related issues.  The Health Forum does not have any legal powers, but has been given local powers by the CCG.  It works very closely with Essex HealthWatch, who do have legal powers.

Their important reports, including local Health Forum meeting dates, agendas and minutes and similar material relating to the Health Forum Committee can be found on their site in the Library.

Get Involved at Local Health Forums

The Health Forum holds local meetings which any public member of the CCG  can attend, regardless of where they live.  The 3 local meetings are held at Colchester; Harwich; (rest of) Tendring – this is usually held in Clacton.  

The next meetings are being held on 2nd, 3rd & 4th February (2pm – 4pm) respectively.  The agenda vary slightly both from meeting to meeting but also by location, but will typically include items such as those due to be discussed in the February meetings:

  • NE Essex Community Pharmacy Scheme
  • CHUFT Cancer Services (Clacton & Harwich only)
  • Borough GP Care Advisory Service (Colchester only)
  • Carer Strategy Consultation
  • General Q&A

These meetings give Health Forum members a chance to receive presentations and ask questions relating to key health care issues and services in their area.  They are also to raise concerns with the NEE CCG staff directly and Health Forum Committee members.

The Agendas for the local meetings are set by the Health Forum Committee who request speakers on the subjects they believe local people want to hear more about.  The CCG supports the Health Forum Committee by finding suitable speakers and health professionals that are in a position to answer relevant questions.

All three local meetings are usually held within a week of each other and they occur bi-monthly (every other month).  The dates of future meetings can be found on their events page

The agendas and minutes of the Local Engagement forum are published in their Library under Health Forum.

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Antibiotics Crisis

ne-essex-ccgMany may have heard about super-resistant bugs able to thrive despite antibiotics, the NE Essex CCG has issued advice that will help reduce the problem.

Antibiotics crisis – we can all do our bit locally

Patients and doctors together can help keep antibiotics effective.  NHS NE Essex CCG is asking both doctors and patients to support each other locally to do our bit in the battle to keep antibiotics effective for us. The prime minister said:

If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine where treatable infections and injuries will kill once again.

Dr Hasan Chowhan, clinical lead in this area for the CCG said:

bacteriaWe have known about the growth of resistance for some years, but it is getting rapidly worse.  Research continues to look for more antibiotics to counteract bacteria that cause serious diseases in humans, but many bacteria are becoming more resistant to medicines currently available.  What this means is that now around 5,000 people a year in Britain die because of antibiotic-resistant infection.  If current trends continue, major life-saving surgery will become extremely risky, as post-operative infections may not be treatable.  Even smaller, less serious operations of all types will become hazardous, as the risk of serious, even fatal illness from resulting infections will be too high.  This is a major problem facing all of us and our families.  The prime minister and the Chief Medical Officer are absolutely right to sound the alarm.

Dr Chowhan is calling on local doctors and patients to support each other:

We know that in too many cases locally, doctors prescribe antibiotics for patients when it is very unlikely they will do any good.  Coughs, colds and various other usually minor illnesses caused by viruses cannot be cured or even helped by antibiotics.  Indeed often antibiotics will cause other problems for the patient, such as very unpleasant digestive disorders, because the antibiotics kill the stomach and intestinal bacteria that manage our normal digestion.

Doctors can sometimes play it “safe” by prescribing just in case the patient might be aggrieved and complain if they didn’t.  Sometimes the patient will insist on getting “some pills” or “some antibiotics” as they are sure that will hasten their recovery.  Dr Chowhan and his colleagues in the NHS are appealing to patients to listen carefully to the doctor, and not to insist on antibiotics when it has been explained that these may not help, and may indeed produce harm.  The CCG is working with local doctors to support them to understand where unnecessary prescribing is happening and to reduce it.  We know from the recent “Big Care Debate” that local people in general strongly support any reduction of waste in the NHS. When people take antibiotics that are not necessary, bacteria present can develop resistance.  The more antibiotics that are taken by more people, the more resistance develops and can then spread to others, so that the patient concerned and perhaps other contacts develop resistant bacteria.  The end result being that the next time they are treated, the antibiotics don’t work.  Over-use in farm animals and lax regulation in some other parts of the world are also known contributors to the problem. Dr Chowhan concluded:

This is one problem where each and every patient, as well as our doctors and nurses and pharmacists, can make a real contribution to the safety and effectiveness of our medicines now and for our families in the future.  The government’s review is good news, but we don’t have to wait for that, we can do our bit now.

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