GP’s award-winning alcohol service scrapped ‘despite saving NHS £500,000 a year’

A GP behind a ground-breaking, multi-award winning alcohol treatment service has said he almost feels like quitting after the scheme was decommissioned in an NHS cost-cutting drive, warning the decision suggests there is ‘no point innovating’.

NHS commissioners in Cambridgeshire have said they will no longer fund the innovative Gainsborough Foundation alcohol treatment service despite claims it reduces hospital admissions and saves the health service six-figure sums each year.

The service, which covers 26 GP practices in Huntingdon and treats 200 new patients a year, will close in April after the local CCG withdrew funding.

A letter from Cambridgeshire and Peterborough CCG said that it could no longer afford to support the community recovery and detox service because it is not a statutory requirement. The CCG has previously acknowledged that the Gainsborough service had reduced emergency hospital admissions and reduced NHS costs.

GP alcohol service

Dr Arun Aggarwal, the GP who founded the service at his practice with a recovered alcoholic in 2000, said that while neighbouring areas had seen alcohol-related admissions grow by 6% a year, admissions in Huntingdon were falling. The £200,000-a-year programme was saving £670,000 on hospital billed activity every year, he told GPonline. In just three months of 2015, CCG documents show, the service saved almost £100,000 on emergency admissions alone.

But in a letter to Dr Aggarwal, Cambridgeshire and Peterborough CCG chief officer Tracy Dowling said there was no evidence the alcohol service had reduced admissions.  The CCG continued to support the service after responsibility for alcohol treatment passed to local authorities under the 2013 NHS shakeup. Now commissioning bosses, who reported an £11.5m deficit last year and are planning cuts of £44m, have said they will no longer support the service.

From April practices will have to refer patients with alcohol dependency to the existing local authority-commissioned service. But Dr Aggarwal said his programme is more successful.

Detox treatment The Gainsborough Foundation, which was awarded the 2014 GP Enterprise Award, as well as a BMJ and an east of England innovation award, uses non clinically qualified recovered alcoholics to provide recovery and detox treatment in patients’ homes. The service has, said Dr Aggarwal, a 60% success rate breathalysed dry at two months, while patients are seen much quicker than in traditional services.  A survey of local GPs showed 73% believe the Gainsborough service is ‘invaluable’ while 83% rate is as more effective than the local authority service.

‘There have been no arguments about its efficacy or safety or outcomes,’ said Dr Aggarwal. ‘They have all been ignored.’

The GP said the CCG’s decision was short-sighted and would do little to help resolve the local NHS’s finance problems which were the consequence of unfair funding.

‘I think they have had management teams coming in saying the only way to solve your funding formula problem is to cut everything you are not statutorily responsible for’, he said.

GP innovation

Dr Aggarwal said the decision was ‘totally demotivating for GPs trying to be innovative’.

‘The combination of … this cut in the alcohol service and other hassles …  is almost enough to make me hand in the keys,’ he said. ‘In this current era there is no point innovating.’

In a statement on its website Cambridgeshire and Peterborough CCG chief officer Tracy Dowling said: ‘The CCG has taken the decision to serve notice on the alcohol support service provided by the Gainsborough Foundation for patients in the Huntingdon area.

‘Although the CCG has previously funded alcohol support services from Gainsborough Foundation Trust in the Huntingdon locality, the funding and Responsible Commissioner duties for Drug and Alcohol Services transferred to Cambridgeshire County Council Public Health commissioners in 2013. Inclusion is the organisation commissioned by CCC to provide these services across all of Cambridgeshire.

‘The CCG receives a fixed budget to buy and provide health services for the entire local population. Like all CCGs up and down the country, there is greater demand on our budget than we have the budget to spend. We need to look at all our services, and can only commission those we have the funding and responsibility for.

‘Our priority is to ensure that patients can continue access to support services when they need and will work with our partners and service users to ensure this happens.’

Source:   Feb.2017

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