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Norfolk CCG pulls plug on Admiral nursing service to make savings

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A specialist nursing service for dementia patients is to be discontinued in part of Norfolk because of pressure on local commissioners to make “efficiency savings”.

South Norfolk Clinical Commissioning Group said it had concluded that it could no longer continue its Admiral nurse service.

“We cannot afford to continue with a service we know is inequitable and unsustainable”

Antek Lejk

It was not possible to commission an “effective and equitable” Admiral nurse service for the “very limited money” available, the CCG said in a statement issued on Tuesday.

However, the CCG stated that it was “committed” to working with patients, clinicians and other partners to find ways of supporting families who care for someone with dementia.

The decision was confirmed by the CCG’s governing body at a meeting on 27 September, as revealed in board papers.

A workshop will be held on 27 October to discuss the outcome of the decision to stop the service, and to “help inform the development of support”, said the CCG.

The service in South Norfolk was first established as a two-year pilot, funded by the People’s Lottery and Norfolk and Suffolk NHS Foundation Trust. It was run in partnership with Dementia UK, Age UK Norfolk and the mental health trust.

When the lottery funding was due to expire, the CCG stepped in with a grant while a different – but more limited – model was trialled, as previously reported by Nursing Times.

However, South Norfolk CCG said it was faced with making savings of nearly £14m pounds during the current financial year.

But it said it was actually looking at ways to save £17.7m “in the knowledge that there is always slippage and some programmes will not deliver”.

It blamed the economy drive on needing to make up for its 2015-16 deficit of more than £8m and the fact that the cost of providing NHS care on its patch “continue to outstrip the budget available”.

A spokesman for the CCG told Nursing Times that the value of the in-year savings expected from the cancellation of the service were “yet to be finalised”, due to it being part of a block contract with Norfolk and Suffolk FT.

“The service currently employs 2.35 whole time equivalent Admiral nurses,” added the spokesman.

The CCG’s in-year deficit at the end of August was £461,000, according to the board papers. It is forecasting a deficit of £2.1m for the entire 2016-17 financial year, leaving it with a cumulative deficit of £8.7m when added to debts accrued during previous years.

Antek Lejk, the CCG’s chief officer, said: “We know this decision may be disappointing, however we cannot afford to continue with a service which we know is inequitable and unsustainable.

“In the current climate we have reluctantly concluded there is no other realistic option,” he said.

“We do recognise the importance of providing support for people with dementia and their carers. We are inviting members of the public to get involved in how we can effectively meet this need,” he added.

“This service… has produced very positive results”

Hilda Hayo

The commissioner also noted that no other CCGs in Norfolk and Waveney currently fund Admiral nurses.

Dr Hilda Hayo, chief Admiral nurse and chief executive of Dementia UK, said: “Dementia UK is really disappointed to hear that the South Norfolk CCG have decided to decommission the Admiral nursing service.

“This service has been giving specialist support to families living with the complex effects of dementia, and has produced very positive results,” she said. “In addition, an evaluation of the Admiral nurse service had shown cost savings for both health and social care budgets locally.

“We will be speaking to the CCG and Norfolk and Suffolk Foundation Trust about this decision, and to the families currently being supported by the Admiral nurses,” she added.

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Readers' comments (2)

  • Admiral nurses need to get audited while they still exist to audit.

    CCG managers are often very ignorant of the ways in which decent care at the point of delivery is by far the most cost-effective way and humane to deliver care - care which does not result in nurse retention crises and all the extra expense that that involves plus the deterioration of health for the carers with subsequent extra health and social costs. Assuming of course that they are not going to rely on covert bad practise.

    Sometimes these managers are just doctors with accountancy training and are people who are astonishingly short sighted about the ramifications of their antics. The best cost-cutting exercise might be to lose the short sighted CCG managers who do more harm than good and cost way too much.

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  • i agree with the above comment. CCG managers are often non-clinical and have no idea how services are provided and the good cause and effect. what next i ask myself. we theoretically got rid of PCT's that cost an extraordinary amount to fund. now we have CCG's!!!

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