This was raised at our first East of England Citizens' Senate meeting on Tuesday. Members were concerned about CCGs offering different levels of service for IVF across the region - with the suspicion that there would also be variation in access to other services. They wanted to know how, as a region, we could tackle this, and why it had been allowed in the first place when 'equity of access' is such a key driver for the new NHS.
Salaried dental services,in my area,seem to work based on the doctors post code.this can mean that services are not equally available to patients.Practically it also means a delay in accessing treatment as referrals sent to the "wrong facility" are returned to the referrer or redirected
Local commissioning for local need is all very well but how is it actually fair? Who decides the local need? Yes, in theory HWBs & Healthwatch in conjunction with commissioners etc, but I have just been looking at 2 & 5-year CCG plans and the majority in my view don't have sufficient evidence of public engagement. My local Healthwatch for one says it was definitely not consulted. Even if there are areas of good practice this is no consolation to the person in the next postcode #postcodelottery
I think we have to debate whether we want to support local areas having different practice and priorities - is a postcode lottery always bad? What do we want to set nationally and what do we want to set locally?
Equity of access under CCG-driven services is almost a contradiction in terms. CCGs set their own priorities, so how do you avoid different levels of provision for, say, fertility treatment or Wheelchair Services? How do we orchestrate equity of access?
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