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Your Big Health Conversation: Money

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The NHS in our area is seeing its finances get tighter every year - people’s need for healthcare is rising faster than the funding available.

Locally, that growing pressure is especially hard to manage because both Fareham and Gosport, and South Eastern Hampshire CCGs, have been among the worst-funded CCGs (per head) in the country.

Together they have about £1,170 to spend for every man, woman and child. In Portsmouth the number is slightly higher, at about £1,300 for every person.

That money has to pay for the vast majority of the care the NHS provides – babies being born, drugs being prescribed, home visits from GPs or community nurses, ambulance calls, mental health referrals, and almost all of the appointments and operations at Queen Alexandra Hospital.

In recent years the local NHS has worked hard to make that money go further, with much success – until last year, the budgets were kept in balance despite the relatively low funding levels, and the growing demands on local services and staff.

But last year, the sums didn’t add up. Across Fareham and Gosport and South Eastern Hampshire, the two CCGs serving these areas overspent by a combined £5m during 2015/16. That might not sound like a massive amount in the grand scheme of things, but any overspending in one year produces a ‘double-whammy’ effect – not only do you have to reverse the spending which caused the problems in the first place, you also need to repay the debt.

And this year, the numbers again won’t add up. At present the two CCGs are forecasting a combined overspend of £13.5m – once more, spending which has to be slowed down or reversed, and a debt which must be repaid. Portsmouth CCG expects to balance the books for 2016/17, but pressure is growing and the NHS Trusts which deliver care in the city are also sliding into the red.

Money will remain tight for the foreseeable future. NHS costs rise at about 4% a year, but our CCGs will receive funding increases below that level until 2020 at least.

When money is already tight, when the health needs of local people are rising, when costs are increasing, and when there are debts to be repaid – something has to change. Carrying on as before, looking to trim budgets here and there, is no longer achievable.

So the local NHS needs to take stock of how it spends its money, and talk to residents and clinicians about what changes must be made to make sure that the services people need are protected and strengthened.

So how should the local NHS respond? Tell us: “Your Big Health Conversation – talk to us”