Nearly a third of CCGs consider rationing services

Nearly a third of clinical commissioning groups have implemented or are considering restrictions to services this year, HSJ research reveals: almost a third of CCGs have implemented or are considering restricting access to services; CCGs are making joint decisions in their region on procedures of “limited clinical value”; and commissioners have brought in limits amid financial pressures.

HSJ sent freedom of information requests to all 209 CCGs asking whether they had introduced or planned limits to access or eligibility for services during 2015-16 for financial, efficiency or value reasons. Thirty-four CCGs said they had introduced or approved restrictions, out of the 188 groups that responded. Thirty-three said they were considering changes or that their plans were under review. The research found that neighbouring CCGs have tended to make joint or similar decisions, particularly on procedures deemed to be of “limited clinical value”.

For example, all CCGs across Nottinghamshire, except Bassetlaw, have agreed to a joint commissioning policy on such procedures. The document lists a raft of treatments, including surgery for sleep apnoea and hysterectomy for heavy menstrual bleeding, which the groups say “can only be paid for by the local NHS in certain restricted circumstances”.

Seven CCGs across Birmingham, the Black Country and Solihull are also developing a single set of agreed clinical commissioning policies and in the South West, Bristol and South Gloucestershire, CCGs agreed in June to new policies to restrict access to acupuncture, adenoidectomy and post-operative physiotherapy, which will be implemented once local trusts agree to the contract changes.

North East Essex also plans to bring in thresholds for non-urgent elective surgery on the basis of whether patients smoke or are overweight, while Mid Essex is considering changes to continuing healthcare.

Full story in The Health Services Journal 3 September 2015