At the end of 2018, the Derbyshire Clinical Commissioning Group cut all funding to 19 local voluntary organisations providing support to people in the community. Grants totalling £299,114 came to an end, closing befriending, night-sitting and "home from hospital" services.
We are all used to disconnects between government policy and local implementation, but this looks like an extreme case.
The NHS Long Term Plan, published in January, just a month after these cuts were decided, includes a commitment from the NHS to the commissioning and championing of local voluntary organisations in reducing health inequalities, and providing services and support to vulnerable and at-risk groups.
Throughout the document, the voluntary sector is highlighted as part of what will build the future of the health service and the central role volunteers play in supporting people is recognised. Not in Derbyshire it seems.
Social prescribing schemes have enjoyed a boost in NHS funding recently. It is these schemes that often lead to vulnerable people getting support from befriending services.
A recent review of academic literature by the University of Westminster shows social prescribing contributing to a 28 per cent reduction in the number of GP appointments and an average reduction in A& E attendance of 24 per cent.
If NHS England decides it is essential to invest in schemes that support people at home, how can it permit its delivery arm – the Clinical Commissioning Group – to disinvest?
Gill Geddes, chief executive of Voluntary and Community Services Peaks and Dales, tells me that more than 5,000 elderly and vulnerable people in her area will lose transport, befriending and respite care services.
She says: "I fear it is a decision the CCG will come to regret, as the pressure on primary, acute and emergency health services increases but the voluntary sector’s capacity to respond is reduced. This will only increase the risk that a simply resolved situation becomes a crisis."
Neil Moulden, chief executive of Derbyshire Dales CVS, says: "Everyone understands that the CCG has serious financial challenges. But removing this funding seems short-sighted and runs contrary to its stated aim of caring for people in the community."
One clue to the CCG’s decision-making lies in the attitudes of its chief executive, Dr Chris Clayton. Back in 2012, in a Health Service Journal article, he argued that people who end up in hospital rarely question whether the NHS and its partners might have better invested their scarce resources to act on the causes of ill health.
"Our traditional approach to improving health in communities has been to allow unhealthy social systems to generate ill health, then to seek to ‘buy back’ lost health through expensive hospital treatment," he wrote.
So far, so good. But Clayton went on to describe joint working in his former patch, Blackburn with Darwen, where only the public and private sectors figured – no mention whatsoever of the voluntary and community sector.
So can NHS England watch the destruction of prevention services in Derbyshire and the undermining of its long-term plan commitments and do nothing? I sincerely hope not.
Kevin Curley is chair of Community Action Derby and a voluntary sector adviser