PLANNED savings of more than £23m are not enough to meet the demands of brutal government limits on health service spending, NHS bosses in South Cumbria have revealed, as they describe the “significant pressure” placed on them to reduce spending quickly.

But those responsible for patient care remain defiant in refusing to consider anything they feel would compromise patient safety. The Morecambe Bay Clinical Commissioning Group, the GP-led team responsible for deciding which health services are run in South Cumbria, and the University Hospitals of Morecambe Bay NHS Foundation Trust, which runs Furness General Hospital, have both spoken out in response to concerns raised by the British Medical Association last week.

Read more: South Cumbria health cuts 'shrouded in secrecy', doctors’ union claims

The doctors’ union accused health leaders in 13 areas of the country, including Morecambe Bay, of burying details of proposals made under the Capped Expenditure Process. The CEP was introduced in April, and instructs NHS commissioners and providers with the largest budget deficits to make considerable cuts in order to achieve financial balance by April 1, 2018.

The BMA reported last week how health chiefs felt they were being “bullied” by NHS Improvement and that they were being asked to “think the unthinkable in no time at all”.

Responding to the body’s claims, Andrew Bennett, chief officer of Morecambe Bay CCG, said: “As leaders of the Morecambe Bay Health and Care system, we have come under significant pressure to consider all available options, however difficult, to close the financial gap at a greater pace, but we must be clear, we will not adopt an approach which could compromise the safety of our patients or workforce – their safety remains our priority.”

Echoing these sentiments, Jackie Daniel, chief executive of the area’s hospitals trust, explained how local health chiefs have already been working hard to achieve savings as part of their Better Care Together programme. The initiative, which looks at changing how healthcare is provided across South Cumbria and North Lancashire, has seen significant improvements in service delivery and ratings by national health service watchdogs.

Ms Daniel said: “Our Better Care Together plans, which we have committed to deliver, included a need for short term financial support in the form of a ‘Local Price Modification’ and for the LPM to reduce in time as the system was brought back into financial balance.

“As part of those plans, local partners also committed to deliver significant financial improvements over the period – with partners having delivered over £15m of savings in 2016/17 and with plans to deliver a further £23m in 2017/18. However, these plans are not enough to achieve the financial control total set by NHS Improvement and NHS England for this year.

“We have recently been requested by NHS England - as part of the now well-reported 'Capped Expenditure Process' - to consider any further opportunities in order to close the financial gap in 2017/18. As part of this request, we are considering all options and are revisiting some of the areas previously considered in the development of the original Better Care Together Strategy.”

All options are still to be formally considered, Ms Daniel added, and would include a quality impact assessment, a thorough financial appraisal and a view as to the impact on the longer term strategy. If any of the schemes were to progress past this stage, all relevant and required stakeholder engagement would be carried out.

Ms Daniel reiterated that health bosses had strived to be “open and honest” throughout the Better Care Together scheme so far, and would continue to do so.

She added: “We still believe that the right approach to transforming healthcare and reducing the deficit is to continue with Better Care Together - a clinically led plan to integrate care and bring healthcare closer to where people live and doing so within the resources available to us. We remain committed to discussing any ideas with our workforce, the public and stakeholders and we will seek their views and ideas too.

“This has been a difficult time as sustained pressure and increased demand has been felt right across the country; however short term solutions which have not been properly thought-through would not serve us or our local populations well.”

The Capped Expenditure Process (CEP): What is it?

Providers of hospital, ambulance, community and mental health services are expecting to overspend their budgets by nearly £500 million this year, and funding growth in the NHS remains relatively slow. To respond to the resulting financial pressure, NHS England and NHS Improvement introduced tighter controls on NHS spending.

The CEP aims to contain or ‘cap’ spending in specific areas of the country, focusing on health care systems (including both commissioners and providers of health care), rather than individual organisations. It is targeted at commissioners and providers in selected areas of the country, said to have had he largest gap between their planned expenditure for 2017/18 and their budget allocation.

Central bodies claim these areas have been historically overspending their ‘fair share’ of NHS funding and do not have affordable financial plans for this financial year. Consumer groups in some areas, however, argue that historical under-funding of clinical commissioning groups in their regions has not been adequately accounted for. Some providers have also challenged the assumption that the spending caps allocated to providers and commissioners are both fair and achievable.

Read more: Secret NHS cuts will cause uproar once revealed, doctors claim

Read more: Some NHS bosses 'told to think the unthinkable' in bid to meet financial targets