South Warwickshire Clinical Commissioning Group (CCG) has drawn criticism for suggesting patients pay for their own crutches, walking sticks and neck braces which are at present free.
According to a report in The Guardian, Sue Lear, a “service design and innovation” official working on behalf of the CCG, told its patient and public participation group last week that it was keen to reduce its annual £421,000 bill for orthotics.
Its overall annual budget is £304m and it commissions and funds treatment for the 270,000 people.
The report says her presentation posed questions about the viability of introducing charges. “Would it be reasonable to ask people to contribute to the cost of orthotics, aids and appliances? If so, which items and how could we agree this? If so, what criteria should be applied, e.g. low-cost items below a specified threshold?”
Lear also listed 15 different types of aids or devices to which charges, or contributions from patients, might be applied.
They were: ankle foot orthoses, i.e. foot drop splints; wrist splints; trusses, e.g. for hernias; spinal supports; knee braces; hip braces; lumbar/sacral/abdominal supports; spinal support, e.g. for fractures; cervical support collars; helmets; toilet aids & equipment; perching stools; walking aids walking sticks, crutches, frames; bed mobility aids sticks, beds, grab handles; and bath seats.
Many such pieces of equipment are never returned by patients once they have finished with them and so cannot be reused, increasing costs at a time when money is tight, Lear is reported to have said.
However, patient representatives told her that charges would deter some who needed such devices from obtaining them and that any means-testing would prove very complicated to administer.
Those present at the meeting said the proposal, which Lear described as “tentative”, was given a hostile reception.
The CCG wanted to gauge reaction to the possibility of introducing what she called “self-funding for orthotics”, which suggests that it may expect at least some patients to pay the full cost of their device.
The move, uncovered by the anti-cuts group False Economy was rejected by NHS England, trade unions and charities.
A spokesman for NHS England said: “NHS services are free of charge, except in limited circumstances sanctioned by parliament. An approach like this would appear not to meet these criteria.”
The CCG refused to answer questions about what it called a “very early-stage” proposal, including who had come up with the idea.
In a statement, it stressed its need to save money.
“NHS South Warwickshire CCG is committed to the NHS’s key principle of free at the point of use. At our latest patient and public participation group, one of our discussions was about how to improve quality and value for money of our orthotics service,” a spokeswoman said.
“A number of avenues were discussed, in particular helpful comments about the equipment returns process and whether charging for equipment should be considered. This has not been discussed further.”