Delays forming commissioning groups for NHS services threaten the survival of charitable service providers, according to the fundraising manager of the Bobath Centre which specialises in support for children with cerebral palsy.
The Bobath Centre announced in February that it was facing an uncertain future due to "a two-pronged attack of economic downturn and drawn-out NHS reform".
The Centre requires £1.2m every year to provide therapy and advocacy services to its patients. But it is currently facing a £280,000 deficit.
It gets the majority of its funding from patient referrals to the centre, which then helps the patient apply for funding from primary care trusts for the treatment. But Kevin Gillespie, the centre's fundraising manager, has warned that the changing landscape in NHS commissioning, coupled with "a 40 per cent reduction in commissioning staff at primary care trusts" are preventing funds from reaching those who need them:
"The funding has either been stopped in some PCTs or it's being slowed down, we’re having to jump through more hoops in order to get the child to the centre. We believe the money is still there, it’s just not finding its way through," he said.
"We understand that changes are going ahead and we don’t take a political stance on this. But the frustration for us is that children who were being treated are no longer being treated, and this has potentially serious consequences to their development."
Flawed application process
Gillespie alluded that there is a need for more joined-up thinking throughout the commissioning process.
“There’s no generality about this – some funders are great, they continue to send children and it’s very easy for us, and that’s great. But what we’re finding is that we have everything inbetween, from just not answering the phone because we’re guessing there’s nobody to answer the phone because the cutbacks have forced redundancies in the commissioning groups, to having to fill in 60 or 40-page application forms to try to prove that the funding will be of long-term benefit.”
This can result in a very time-consuming application process, he added.
“Every Primary Care Trust will have its own referral protocol, so it’s not as if we’re having to answer the same question lots of times, we’re having to answer the same question but in a different way, and that takes an enormous amount of time. And you’re not talking about an admin officer doing this, you're talking about a senior clinician having to sit down and spend three hours filling out a form. So if they're spending this time filling out forms, they're not seeing patients.”
In addition, he says the applications are too generic. Gillespie says that many of the questions which are aimed at determining the merit in providing funding are irrelevant to people with cerebral palsy, for instance asking whether the funding would go some way to curing the illness - cerebral palsy is an incurable neurological disorder.
Bobath Centre future
Gillespie says the future of the Bobath centre remains unclear, but it has entered a fundraising push to raise £220,000 towards next year's services. It is also undertaking an internal review looking to save £100,000. Gillespie advises, however, that redundancy is not an option as it would produce a false economy:
"When we come out the other side we will need qualified and experienced staff, because they are what makes this service. For instance making therapists redundant now would only cost us in the future because the cost and the time in recruiting would leave a gap in the service."
The Centre has met with MPs Mike Freer and Paul Maynard, who Gillespie says have been very helpful, but there is no simple answer, he said:
"In an ideal world what we'd like is for the PCTs across the country to sort themselves out, form their commissioning groups or clusters and get back in business, but what we're finding is that we're struggling to get answers, sometimes to get any answer, and the slowness that it's taking is really what's killing us at the moment."