Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) is set to announce a series of 'urgent and necessary' measures to address a worsening of its financial situation.
The organisation has an overall budget of £1.1 billion and serves a total population of 898,523.
It is responsible for commissioning, or buying, most healthcare services for the population of towns and cities including Exeter, Plymouth, Exmouth, Honiton, Sidmouth, Crediton, Cullompton, Budleigh Salterton, Ottery St Mary, Tiverton, Okehampton, Axminster, Seaton and surrounding rural areas.
The CCG plans local healthcare and buys services from large acute hospitals, such as the Royal Devon & Exeter Hospital, along with community services and mental health services.
Last year, NEW Devon CCG returned a £14.5 million deficit and this year it had been predicting the same.
But its confidence in meeting this at the end of the current financial year has gradually declined as demand for services is outstripping what it can afford.
The CCG said that whatever the actual cause of the increase in demand, it is having a serious effect on its financial position and if it fails to deal with it now, services will suffer.
Rebecca Harriott, the CCG's chief officer, said it would be prioritising services in the NHS Constitution.
"We must act to protect essential services through our busiest winter months and ensure that care is there for our patients when they really need it," she said.
"The CCG has already begun to implement a series of measures designed to improve efficiency in the system and encourage patients to contribute to improving their own health outcomes.
"This includes the following:• Requiring morbidly obese patients to lose weight prior to routine surgery• Requiring smokers to quit for at least six weeks prior to routine surgery• Introduce criteria-based approval for routine procedures such as hernias, botox injections and cataracts• Reduce unnecessary consultant to consultant referrals• Suspend treatments where there is little or poor evidence of outcomes
"These measures bring the CCG into line with similar organisations in the NHS. However, they are not enough.
"The CCG is working up a series of measures to prioritise those patients most in need, while at the same time, increasing efficiency in the wider system – and the CCG itself.
"Our clinical chairs (who are family doctors) and managing directors are now busy working up proposals, in collaboration with NHS England and others, so that we can submit a paper to the next Governing Body on November 5."
This paper will be published on the CCG's website on October 29.
The CCG has already saved £2 million in its running costs but said it is now intending to make the organisation even more efficient - cutting more internal costs.
The CCG stressed that it intends to prioritise those services and requirements laid out in the NHS Constitution.
They include:• Consultant-led treatment within a maximum of 18-weeks from referral for non- urgent conditions• Maximum four-hour wait in A&E from arrival to admission• Maximum seven-day wait for follow-up after discharge from psychiatric in-patient care• Being seen by a cancer specialist within a maximum of two weeks from GP referral where cancer is suspected• Maximum 62-day wait from referral from an NHS cancer screening service to first treatment• Patients waiting for a diagnostic test should have been waiting less than 6 weeks from referral• Ambulance trusts to respond to 95 per cent of category A calls within 19 minutes of a request being made
Rebecca Harriott added: "To meet the challenge of prioritising patient need while at the same time meeting our control total, the Governing Body will be asked to temporarily change how we work.
"We are intending to split our management and administration resource between 'business as usual' and 'in-year priorities'."
