THE DISTRICT is facing a £43 million black hole in its budget for health services – with a warning that “difficult decisions” lie ahead.

Despite widespread concern about the shortfall and the impact it could have on services such as repeat prescriptions, mental health and some urgent and emergency care, the area’s three clinical commissioning groups (CCGs) and its hospital trusts are adamant cuts must be made now.

City and District CCG bosses insist the difficult months ahead will also be about trying to improve service quality for patients by scrapping any waste, whether it is repeat prescriptions which are no longer needed or unnecessary duplicate appointments or x-rays.

Nationally, the NHS needs to save £22bn by 2020/21 and, for local CCGs, there is a gap between their annual budgets and the increasing cost of providing healthcare to Bradford residents.

In Bradford Districts CCG, this gap is around £10.4m which comes in at just about three per cent over its £495.5m budget. For Bradford City CCG, the £2.6m in savings required from its £154.4m budget tips just over 1.5 per cent of what it has in the pot for 2016/17. Airedale, Wharfedale and Craven CCG revealed there was a gap of £4.6m between its annual budget and the increasing cost of providing health services.

Meanwhile, Bradford Teaching Hospitals NHS Foundation Trust, which runs Bradford Royal Infirmary and St Luke’s Hospital, plans to spend £385m to deliver services but in doing so, it needs to save in excess of £20m. Bradford District Care Trust, which provides services for mental health and social care patients, must find savings of £5.8m.

Matthew Horner, Bradford Teaching Hospital Trust’s director of finance, said: “The Trust is in a strong position to address these challenges but we do so against a national backdrop of significant financial pressures.”

Meanwhile, the District Care Trust’s board, which has approved a 2016/17 budget just topping £131m, hopes to reduce costs by using fewer agency staff and cutting back on running costs for its premises.

In the cost of primary care medicines alone, in 2015/16, Bradford City CCG saw an eight per cent growth and Bradford Districts CCG had a four per cent rise.

Dr Andy Withers, clinical chairman of Bradford Districts CCG, said: “Without making savings now, money will not be available for the future transformation of services; so we must look at how we can innovate, be more productive, prevent NHS resources being used inappropriately and ensure services are still of the highest quality.”

Dr Akram Khan, clinical chairman of Bradford City CCG, said: “Our plans are challenging and difficult decisions will need to be taken, but we will be honest and open about the tough choices we face.”

Plans are being drawn up for a range of schemes to reduce spending, including reviewing the prescription of gluten-free foods, making sure the most cost effective drugs are being prescribed when appropriate and that patients get the appointments and treatments they need without any duplication.

The CCGs will take their plans to Bradford Council’s Health and Social Care Overview and Scrutiny Committee on Thursday. Councillor Vanda Greenwood, chairman of that committee, said: “The district faces big challenges in a changing world where public sector resources are becoming increasingly scarce.

“This report shows Bradford Council, the CCGs, NHS trusts and other health organisations need to continue to work together and find new, innovative solutions to improving health in the area as part of the District Plan.”

Bradford Council leader Councillor Susan Hinchcliffe, chairman of the Health and Wellbeing Board, said: “I share the concerns of the CCGs about the financial gap they are challenged with.

“Simultaneously the social care budgets of local authorities are being squeezed which in turn increases the pressures in the health system.”

A spokesman for Healthwatch Bradford said it was vital that the savings did not make problems worse for patients.