Cash shorfall threatens Herts operations
PUBLISHED: 07:00 28 November 2009 | UPDATED: 14:41 06 May 2010
A COST-cutting health trust is reducing a range of treatments unless funding approval is given. The West Herts and East and North Herts Primary Care Trust (PCT) has listed 18 procedures for which agreement has to be reached in advance before they can be c
A COST-cutting health trust is reducing a range of treatments unless funding approval is given.
The West Herts and East and North Herts Primary Care Trust (PCT) has listed 18 procedures for which agreement has to be reached in advance before they can be carried out.
They include hysterectomies, elective hip and knee surgery, cataracts, back injections, hand surgery, tooth extraction, varicose veins and epidurals for chronic pain.
The list could be extended once further guidance has been agreed.
The situation has arisen because the PCT is facing "significant financial challenges" relating to a considerable overspend against budget which has been primarily caused by spending on acute treatment.
As part of a financial recovery plan, the PCT is aiming to keep treatments which they describe as being of limited clinical effectiveness as low as possible.
Unless prior agreement if obtained by the providers of health services in Herts, the PCT will not fund the treatment.
A letter from the PCT's contracts manager Jan Ashcroft to providers of health care says that the objective is not to delay access to cost-effective treatment but to identify cases where the success of treatment is not well supported by evidence.
The changes came into effect from November 16 and all patients are now being told that if they are placed on the waiting list for any of the 18 procedures, it will be subject to funding approval.
Cllr Aislinn Lee, chair of St Albans council's health committee, said this week that she was unaware of the situation even though she and fellow councillors had met with Anne Walker, chair of the PCT, and some of her colleagues earlier this month.
The meeting had been to demonstrate how keen the council was to work with the PCT as partners, share information and avoid duplication.
She said the PCT had made them aware of the financial difficulties they were facing but when she had asked whether any services would be removed, she was told not.
In a statement this week, the PCT said it was undertaking a programme of work to make sure it achieved balance at the end of this financial year during which demand for NHS services was above projections.
The PCT was now taking steps to shift treatments and appointments away from acute hospitals and working with GPs and the hospitals trust to achieve it.
Deputy chief executive, Dr Jane Halpin, said: "Our work with hospitals and GPs is about patients being referred at the right time and treated in the right place. For instance some procedures, such as tooth extractions, can usually be done safely and effectively outside hospital.
"For other procedures, such as tonsils or grommets, there is a wealth of scientific evidence that states that it is better to wait to see if symptoms resolve themselves before carrying out surgery."
She explained that in those types of cases a clinical team would check that procedures fell within well-established guidelines before giving approval for them to be carried out. The PCT was also aiming to focus its resources on treatment which would be of maximum benefit to patients and the public.