The NHS is increasing spend in Nottingham and Nottinghamshire for 2024/25, but the demands on health and care services are rising. This means all partners in the Nottingham and Nottinghamshire Integrated Care System need to work together to transform the way that health and care services are delivered across our geographical area. As part of this approach, Nottingham and Nottinghamshire Integrated Care Board (ICB) need to make decisions about how spending is prioritised to achieve the best value.

All services are being reviewed to check that they are having the desired impact and are affordable. In some instances, the focus is on increasing productivity and efficiencies in the way that services are provided. This ensures that we make the best use of our facilities and workforce. This will be done working with clinicians to check that there is no duplication of services and that services offered are evidence-based and demonstrably beneficial to patients.

The proposed changes have been split into three different groups which can be found below.

Alongside this, we will continue to deliver on our positive developments including:   

• Health Inequalities Innovation and Investment Fund to help those people who are currently the most disadvantaged through more personalised, targeted support.
• Integrated Neighbourhood Teams which bring together local councils, health and social care, community groups, voluntary sector organisations and citizens to find ways to improve the health and wellbeing of local people.
• Sharing and analysing data from across organisations to make sure we are targeting services and support where it is needed.
• Improving primary care access by continuing to recruit to additional roles in primary care, rolling out new digital solutions and systems and increasing the offer from pharmacists. GP appointments increased by 5% compared to the first three months of last year (NHS Digital data from January – March 2023 and 2024)
• Improving urgent and emergency care by maximising the use of virtual ward beds to support patients who would otherwise be in hospital (focussing on frailty and respiratory capacity), embedding and expanding the Urgent Care Coordination Hub to make sure clinicians have a single point of access to ensure our patients receive the right care in the right place first time.
• Significantly reducing waiting times for treatment. 78 week waits have been eliminated and 65 week waits are down by 21% (from April 2023 to February 2024).

Group 1

Administrative costs and estates

Group 2

• Business as usual efficiencies e.g. switching from branded medication to cheaper generic alternatives, savings on admin services to GPs including IT updates, SMS software and training support.
• Changes to contracts e.g. combining Urgent Community Response contracts to have one consistent offer, reviewing musculoskeletal and gynaecology referral pathways
• Deferred investment (still providing business as usual but no additional spending) e.g. Community Diagnostic Centres, prevention and long-term conditions
• Adherence to eligibility policies e.g. reviewing packages of care for people receiving Continuing Health Care funding to ensure they are right for people’s needs.
• Maximising national income: improved reporting of planned care activity to ensure we are paid for all services delivered.

Group 3

Proposals that may change services – details to follow.

We regularly update the Health Scrutiny Committee at Nottingham City Council and Nottinghamshire County Council with our latest information on financial sustainability. View the papers for Nottingham City Health Scrutiny Committee and Nottinghamshire County Health Scrutiny Committee.

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