Dr Nick Tupper blog: deciding how to spend £428 million

nicktupperLast week I had the pleasure of chairing our members’ annual general meeting, marking our second full year as a clinical commissioning group (CCG).

It was a great opportunity to look back on what we have achieved in 2014/15 and to share our plans for the current year. CCGs are membership organisations and our members are the 43 GP practices that are based in Doncaster borough.

Those practices and the GPs that work at them are key to helping drive forward the health improvements we want to make in Doncaster.

In fact, many local GPs combine their roles at practice with providing advice and expertise to the CCG. Dr Marco Pieri, for example, is a GP at Scawthorpe but he’s also the CCG’s cancer lead, responsible for taking forward our plans to detect cancer earlier so patients can have fast access to treatment and a fighting chance of beating the disease.

Similarly, Dr Karen Wagstaffe is GP at Barnburgh but her special responsibility at the CCG is for looking at ways of improving and enhancing dementia services. We want local people who have dementia to be diagnosed earlier so they can have the support they need to live well with the disease.

Understanding the role of a CCG can be difficult if you’re not familiar with how the NHS functions. Most people know their local surgery and their local hospital as that’s where most of their contact with health workers takes place. Our role is more behind the scenes – planning, organising and overseeing the health services Doncaster people need, and last year we spent our £428 million budget doing just that. It funded, such as, countless operations at Doncaster Royal Infirmary and Bassetlaw hospitals and around £60 million paid for millions of prescription medicines for Doncaster people.

So, in addition to being a clinician, I work closely with manager colleagues at the CCG to keep a tight rein on the finances as the NHS does not have a bottomless pit of money. Fortunately, in Doncaster we have good financial management systems in place to ensure we do not spend more than we have in the bank, but it does mean that we often have to make difficult funding decisions in order to remain in the black.

Our budget worked at over £1,380 for every person registered with a GP practice in Doncaster.

In return we spent around £1.17m a day –or over £1,000 a minute – funding a myriad of health services, from district nurses to midwives and much, much more.

Managing the NHS’s finances is tricky at the best of times as we don’t have a crystal ball to see what’s around the corner. But the good news is that in 2014/15 we met all our financial targets and finished the year bang on track, with just £11,000 left from the £428 million we started with.

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