Nearly a third of clinical commissioning groups – the CCGs who hold NHS budgets – have implemented or are considering restrictions to services this year.
Freedom of information requests from the Health Service Journal to all 209 CCGs asked 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.
Further research by the Local Government Chronicle showed that neighbouring CCGs have tended to make joint or similar decisions, particularly on procedures deemed to be of ‘limited clinical value’:
- All CCGs across Nottinghamshire, except Bassetlaw, now regard a range of treatments, including surgery for sleep apnoea and hysterectomy for heavy menstrual bleeding, as “can only be paid for by the local NHS in certain restricted circumstances”.
- 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.
- Basildon and Brentwood CCG in Essex is considering restricting access to specialist fertility services, in line with the existing policies of Mid Essex and North East Essex CCGs.
- North East Essex also plans to bring in thresholds for non-urgent elective surgery on the basis of whether patients smoke or are overweight.
- Mid Essex is considering changes to continuing healthcare.
In March, North Staffordshire became the first CCG in the country to restrict access to NHS funded hearing aids, which it said would save £200,000 in the first full year. The charity Action on Hearing Loss warned it was the “thin end of the wedge” for wider charging for NHS services by CCGs, but the plans were backed by NHS England, which said the group had followed “proper process” and made an evidence-based decision.
Unless this list is to be ever growing the public need to be woken up and told this is going on. People won’t notice their services are being cut until it is too late and they start hearing suggestions that ‘the top-up’ is the best way of getting the care they need: private insurance by the ever-widening back door. They trust the politicians not to take their NHS away from them. That trust is misplaced. Wake up and fight! Join us. Now.