Yorkshire hospitals bust care budget by £40m

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HOSPITALS across the region spent £40m more than expected on specialised care amid major confusion over budgets in the first year of the Government’s controversial reorganisation of the NHS.

Bosses at NHS England have ordered a review into the embarrassing overspend which ran to £377m nationally in 2013-14 after admitting to “significant weaknesses” in specialised commissioning on services ranging from radiotherapy and chemotherapy for cancer patients to kidney dialysis and expert care for rare genetic disorders.

Analysis by The Yorkshire Post has revealed excess spending totalled £44m across the region against a budget of nearly £1.1bn in 2013-14.

At the York and Harrogate NHS trusts, spending was nearly 25 per cent higher than expected, while major centres of care in Leeds and Sheffield were each £10m over budget.

The overspend has been blamed by health chiefs on problems calculating budgets following the abolition of primary care trusts. Responsibility for spending on specialised services, which accounts for more than 10 per cent of the NHS annual budget, was handed to the newly-created NHS England as part of the biggest ever health service shake-up.

Main areas of overspend in Yorkshire have typically been high-cost drugs, notably for cancer. Other high-spending areas have included critical care and specialist care of newborn babies.

Andrew Bertram, finance director at York Teaching Hospital NHS Foundation Trust, said it was now clear initial allocations had underestimated the volume of specialised care at the trust.

He said NHS England’s remit was significantly different and allocation rules had to be “developed and introduced in a very short space of time”.

“The introduction of the new NHS commissioning arrangements throughout England has brought about many challenges to both commissioners and providers,” he said.

“Joint work is ongoing to re-align commissioner allocations to better reflect the true impact of specialised services. We are more comfortable with the 14-15 contract levels now there is a better understanding of allocations.”

NHS England will spend £1.6bn more on specialised services in 2014-15 above its initial April 2013 budget – an increase of 13 per cent. Figures show some NHS trusts have been handed huge uplifts including York which is receiving 30 per cent extra at £34.6m.

An NHS England spokesman said: “2013 was a year of unprecedented change in the way in which specialised services were commissioned, moving from between 10 and 152 different ways of counting, coding and paying for specialised services, to one single approach.

“We have improved access to specialised services where geographical access was previously variable and we have seen significant increases of activity in a number of areas.

“We are reviewing every opportunity to improve efficiency and reduce costs whilst maintaining the quality of services.”