WHEN former Health Secretary Andrew Lansley first sprung clinical commissioning groups (CCGs) on an unsuspecting world back in 2010, he pledged they would be the most important bodies in his vision of a new, radically restructured NHS.
With Prime Minister David Cameron wanting to bring “fundamental change” to the health service, it was decided that healthcare professionals themselves should bring their knowledge and experience of the system to the forefront and be charged with making the big decisions.
Here in Worcester that responsibility has fallen on Carl Ellson, a local GP with 20 years’ experience who now finds himself the chief clinical officer of the new South Worcestershire CCG and the man ultimately accountable for spending a local health budget of about £320 million.
Dr Ellson describes his role, and that of the CCG, as being akin to a “personal shopper” on behalf of the 292,000 patients it serves in South Worcester-shire.
“We get the money and then speak to the health and hospital trusts and the various other organisations and decide how it should be spent,” he said. “The whole theory behind the change in legislation is to put clinicians who have day-to-day contact with patients into the roles and use that experience. Clinicians are the right ones to be driving this time of change.”
With that in mind, it is hugely important to Dr Ellson that he retains that background on the frontline of delivering health care.
He still continues to work as a GP at Corbett Medical Practice, although he has had to gradually strip his commitment there back to one-day-a-week as he balances the demands of his new role.
South Worcestershire CCG will be providing about £125 million of its budget to Worcestershire Acute Hospitals Trust, which runs Worcestershire Royal, Redditch Alexandra and Kidderminster hospitals and about £75 million to Worcestershire Health and Care Trust, which is responsible for community hospitals, with the rest spread elsewhere.
While those may sound like huge sums of money, Dr Ellson and his chief operating officer Simon Trickett are acutely aware that those pots have an awfully long way to stretch.
“Of all the times in the world to put GPs in charge of the health service, it is happening at a time when the money is drying up and the demand is going through the roof,” said Dr Ellson.
Mr Trickett explained: “We probably feel more exposed than any other public service due to an ageing population, a particular factor here in South Worcestershire, and the cost attached to maintaining that. Also people are constantly coming up with new drugs and technologies, but they cost money. The challenge of freeing up money to be able to invest in things is a big one for us.”
He knows that difficult decision will inevitably have to be made and said it would come down to a question of “prioritisation”.
“We are never going to have enough money to do everything all the time. But I want people to take confidence from knowing it will be doctors and nurses taking those decisions,” he said.
While clinicians such as Dr Ellson and his fellow GPS that make up a large part of the CCG board will have to make those choices, they want the public to be as involved as possible in driving those decisions.
With the launch of the CCG comes the introduction of a new “Better Together” scheme that is open to anyone aged 14 and over and registered with one of the 32 GP practices the South Worcestershire CCG encompasses.
Members of the scheme will be consulted over priorities and key decisions and their voices will ultimately have a big say in deciding what health services work for South Worcestershire and what will be available in the future.
Mr Trickett said a huge benefit of the new NHS system was that it offers “much greater scope for us locally to decide what to do, much greater freedom.”
He added: “We want to work with people. We need them to understand the challenges, and understand that we cannot do everything, but we want people to work on those big decisions with us.”
Registration forms for the Better Together scheme are available in GP surgeries or online at www.southworcsccg.nhs.uk/get-involved/better-together.