The Harrogate CCG solution – no prescriptions for OTC drugs – A precedent could be set by neglect..

Harrogate Health Trust commissioning group has suggested stopping prescriptions for substances available over the counter – for everyone. NHSreality suggests this is Knee Jerk Rationing .. The politicians will have to be involved or this will “suggestion” become the norm and established, and inequalities will increase. Other CCGs will immediately follow, and political denial is likely. The poorest people will be subject to the same rules and restrictions as the richest, for whom the rationing will not matter. A precedent could be set by neglect.. Harrogate are on to a winner. They could save large amounts if they are not challenged, and if they are they can blame the politicians..

But there may be some goods and services which are so cheap that everyone should pay for them – 10 paracetamol tablets, skin emollients  – all of which are worth only a few pennies. This could be part of a rational rationing programme, but only after debate. The Kings Fund (today) agrees that the sums cannot add up..Image result for in denial cartoon


So far (3 days) the national media has missed the importance of this announcement. Overt explicit rationing

Harrogate NHS could stop prescriptions for for over-counter drugs

StrayFM news reports: ‘Difficult choices ahead’ as health bosses look to make savings

Stuart Minting for The Northern Echo reports 24th August 2016: Cash-strapped doctors’ group considers stopping providing over the counter medicines and withdrawing services

A DOCTORS’ group is considering stopping providing patients with over the counter medicines, withdrawing services and pressing self-care, as it battles an £8.4m budget shortfall.

Harrogate and Rural District Clinical Commissioning Group (CCG), which consists of 17 GP practices in the Ripon, Knaresborough, Boroughbridge and Harrogate areas, said it was reviewing all areas of its spending, including the services it purchases, medicines prescribed, outpatient appointments and operations.

The CCG said it had plans in place to overcome the multi-million pound shortfall this financial year, but with costs continuing to rise, it was preparing further changes in its spending to bridge the budget gap.

The announcement is likely to come as shock to many as the body which commissions NHS services was last month rated as outstanding by NHS England in its year-end assessment placing the organisation in the top ten out of 211 CCGs nationally.

It unveiled the proposals, which will see a “renewed focus on self-care and healthy lifestyle choices by individuals and may include reduction or withdrawal of certain services that do not improve outcomes”, as it revealed many of its neighbouring CCGs were also facing “unprecedented challenges”, as demand from an ageing and growing population increases.

The CCG said as money was allocated to it from the Government based on the size of the population it had found its budget was stretched further as demand for healthcare increased.

There have been long-standing concerns among health campaigners in North Yorkshire over the amount of funding for NHS services in the county, which is lower per head than in some neighbouring cities due to its perceived low level of deprivation, while it has a higher than average and rising elderly population.

It has been estimated that more than 40 per cent of NHS spending is devoted to people aged over 65 and that an 85-year-old man costs the NHS about seven times more on average than a man in his late 30s.

The CCG has moved to illustrate its financial plight by revealing that from April to June last year and over the same three months this year, the number of people attending accident and emergency increased by 2.7 per cent, equating to an additional £125,000 cost that had not been planned for.

The same periods saw a 14 per cent increase in the number of knee procedures, at an additional cost of £160,000.

The CCG said while over the counter medicines cost it £260,000 to prescribe last year, paracetamol and other painkillers were widely available in supermarkets and chemists and cost around 1p per tablet, compared to 3p per tablet on the NHS.

In response to the budget pressure, it has launched a review of “every service it commissions” to identify how its funds can be best spent and will consult residents about their views on where demand can be reduced and costs curtailed.

The King’s Fund response to NHS Improvement’s finance figures

This entry was posted in A Personal View, Commissioning, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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