15 March 2018

Green Party councillor for Guildhall ward, Denise Craghill, who is the Green Group member on the York Health and Well Being Board, has called for scrutiny of a new scheme brought in by local health commissioners (Vale of York CCG) for dermatology services in York.

The scheme appears to offer GP practices additional funding based on how much they reduce the number of people they refer to York Hospital for dermatological services. Cllr Craghill said

‘This scheme is one of a number across the country characterised as ‘cash for cuts’ schemes and highlighted by campaigners concerned about the future of NHS services. I appreciate that it is prompted by Government funding cuts and the pressures on NHS finances, but I am not assured by the responses to my questions so far that it won’t compromise patient safety. I have been told that all the savings made by the hospital go back into improving the quality of dermatological services in surgeries and that the scheme is helping to cut waiting times for people who are referred to the hospital. That is all well and good, but the obvious concern is that the pressure to reduce referrals could have a very negative impact on individual patients who may not be referred when they should be. Using cash incentives to change clinical behaviour is a path we shouldn’t be going down. If new technology is available that can improve the quality of services for dermatology patients, including more treatment closer to home, then the investment should be made - but it shouldn’t be dependent on reducing hospital referrals. It still isn’t clear if this means that some practices will get the new technology and others won’t, dependent on their referral rates. This scheme should be reviewed either by the commissioners (Vale of York Clinical Commissioning Group), by Health Scrutiny Committee or in discussion with colleagues at the Health and Well Being Board since taking a step down this path is a big strategic change for our struggling local health system.’

See this recent article in Pulse Magazine – one of the leading journals for GPs. It includes a response from Vale of York CCG.