The risk of private providers “playing hardball” if they are asked to help clear NHS waiting lists could make it more difficult for two committees of Lancashire GPs to balance their books.
The Greater Preston and Chorley and South Ribble Clinical Commissioning Groups (CCGs) are forecasting that they will be able to break even by the end of the financial year.
READ MORE >>> Preston and Chorley hospitals start to clear backlog
But the prediction does not factor in the potential need to pay for patients to be sent for pre-planned treatment outside the NHS, in order to meet a government waiting list target.
NHS organisations have been told to ensure that the number of patients waiting for treatment in their areas is no higher by March 2019 than it was twelve months earlier.
But a meeting of the Greater Preston CCG heard that Lancashire Teaching Hospitals - the trust which runs the Royal Preston and Chorley and South Ribble sites - is “some way adrift from delivering on the target”.
In September, the latest month for which official figures have been published, LTH had a waiting list of over 33,000. Back in March, it stood at 31,100.
However, when the trust's own board discussed the issue, there was a more upbeat assessment of the hospitals' ability to hit the target. More than 1,800 patients were shed from the combined waiting list during October, although initial figures for November suggest that the net figure has plateaued because of an increase in referrals.
The area’s two CCGs ‘buy’ treatment on behalf of their patients and if they decide to refer them to other providers instead of LTH, they do not have to make a payment to the trust. But an increase in emergency activity at Central Lancashire’s two hospitals - for which the CCGs are also charged - means any cash coming back to the groups could soon be swallowed up.
“There is not a level of saving which gives me any confidence that I can lift a group of patients out [of LTH] and get them treated elsewhere,” Matt Gaunt, chief finance officer at both CCGs, told members in Preston.
“And it is likely to cost more, because private providers would play hardball [in that situation],” he added.
Other financial pressures facing the CCGs include the cost of drugs for some eye treatments and a requirement to hold 0.5 percent of their budgets as a “risk reserve”.
Collectively, the two organisations have an £800,000 shortfall which is “stubbornly refusing to go away”, Mr. Gaunt said.
Committee members heard that contracts were being reviewed with NHS and private sector organisations to ensure that they are “robust and provide value for money”.