HEALTH services in Oxfordshire are facing a financial crisis as the organisation that buys care has admitted it cannot yet balance its books for the coming year.

Oxfordshire Clinical Commissioning Group’s (OCCG) stark warning yesterday was that it would either have to pay less or do less in the next 12 months as it struggles to plug a £13m black hole.

With less cash coming from central government it needs to axe its spending by £22.4million, but it has only identified £9.1million of savings so far.

The 11-strong OCCG board, which consists five county doctors among its NHS professionals, is responsible for agreeing how to fund healthcare across the county including hospital care, community hospitals, end of life care, mental health services and ambulances. It also contracts out services to organisations such as Oxford University Hospitals, which uses the cash to hire staff, pay for equipment and provide its services.

But because the savings have not been identified, it could mean places such as the John Radcliffe, Churchill and Horton hospitals, the Nuffield Orthopaedic Centre and Oxford Health – which runs mental health services and community hospitals – have less cash.

Direct cuts to services have not been ruled in or out. But the board pointed out there is a growing pressure for its services.

OCCG’s chief executive David Smith told the board yesterday: “Discussions come back to there being more to do with the money than we are able to.

“It’s that combination; it’s either...we do less or we pay less.

“That’s about efficiency and getting better value.”

Healthwatch Oxfordshire’s executive director Carol Moore said by not highlighting where the axe will fall, OCCG risked causing concern in patients and the public.

She added: ‘The CCG says it is working to identify where those savings can be made, without indicating whether it is looking at greater efficiencies or changes to services, which misses an opportunity to allay public concern.”

OCCG also pays for the county’s NHS 111 non-emergency helpline, autism diagnosis centres, and physiotherapy services and has secured an agreement with NHS England to take on responsibility for primary care – such as GPs – with a £90m budget.

Mr Smith stressed integrating health and social care, which is paid for by the county council, was vital if the NHS in Oxfordshire was going to make the savings it needed to.

He added: “Otherwise we are not going to be able to address the challenges we see in Oxfordshire.

“If all we do is pay for more of the same we will not deliver the changes we want.”

The financial black hole emerged on the final day of the £2m pilot scheme to tackle the county’s bedblocking crisis.

The plan was to reduce the number of delayed transfers of care – patients medically fit to leave hospital being stranded in beds because they have nowhere to go – down to 30.

But despite moving more than 290 patients since the scheme launched in November, the total number of patients stuck in hospital beds has only fallen by 28, from 159 to 131 by March 24.

The board heard how despite the slow progress, health leaders were keen to continue investing in reducing the number of delayed patients.

Delivery and localities director Diane Hodges said: “We recommend continuing some intermediate care beds for now, while we continue to resolve the workforce issues.

“We cannot not spend any more money on delays.”

Mr Smith said in order to carry on the pilot scheme, the CCG had to continue to invest in it.

He added: “If we say now we are going to pull the plug on this money then actually the numbers will rocket up and we cannot allow that to happen.

“If we put the money into this that money is not available to go into other areas, such as waiting lists.”

Mr Kenworthy added: “We need to take stock quite quickly.”

The financial situation will be discussed at the next board meeting on May 26 at Banbury Town Hall.