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Decision on prescribing proposals and the decommissioning of Foxley Lane following NHS engagement

​Today, Croydon Clinical Commissioning Group (CCG) approved recommendations to stop the prescribing of gluten-free products, vitamin D for maintenance, self-care medications and baby milk, and to decommission Foxley Lane women's service, an eight-bedded mental health stand-alone unit in Purley.  Foxley Lane women's service is run by South London and Maudsley NHS Foundation Trust (The Trust).

These decisions have been made in the context of the financial pressures the local NHS is facing. Croydon CCG needs to make savings of over £30 million next financial year, which is around 6% of the commissioning budget for local health services of £482.3 million.

Today's decisions follow two engagement periods run from early November last year to Friday 6 January 2017 when the proposals were put to the public to give the local NHS their views.

Foxley Lane

Throughout the engagement process for Foxley Lane, Croydon CCG engaged face to face with almost 150 Croydon residents, patients and professionals and received a total of 57 written responses through the online and paper survey. A petition opposing the closure of Foxley Lane was created on the 38 Degrees website which, when delivered to Croydon CCG, had received 737 verified signatures.

The CCG's decision has been clinically based and reflects the borough's mental health strategy and commitment to treat more patients in the community closer to their own home.  Instead of being admitted to Foxley Lane patients will be provided with individual care packages in their homes where appropriate.  Patients that require more intensive support could be admitted to inpatient services including a new 14 bedded women's ward on the Bethlem site which will open in the spring. These community services will be provided by a range of community mental health services including Croydon Home Treatment Team and the Community Liaison Team.  Last year 55 women were treated at Foxley Lane. By treating patients in the community rather than at Foxley Lane the local NHS could save over £500,000 a year.

Dr Tony Brzezicki, Clinical Chair of NHS Croydon CCG said:

"We want to thank all of those people who took the time to give us their views on our proposals. This insight has meant we have been able to amend and adapt our commissioning intentions to prioritise what is most important for our patients. 

"We have heard first hand at public and community meetings, as well as in the written responses and petition, the passion people feel for Foxley Lane women's service.  Those who responded, felt overwhelmingly that they did not agree with this proposal and they raised a number of concerns that we will continue to work closely with the Trust to address and to make sure those women who are affected will be supported.

"We know that the community mental health services in Croydon can offer patient centred packages of care to support women previously treated at Foxley Lane within their own homes.  We will work with the Trust to embed the Foxley Lane ethos within the community mental health services, which also receive positive feedback from their current patients."

Dr Hugh Jones, Clinical Director, South London and Maudsley NHS Foundation Trust said:

"We have developed a treatment model based around the individual which we are confident will allow us to make sure every patient receives the best quality care.  The number of patients who are referred to Foxley Lane is very small, and we believe we can support all of them appropriately within the range of community mental health services we have in place following £9 million investment in Croydon over the last two years. 

"We would also like to reassure people who raised concerns about mental health inpatient capacity in the local area that the Trust is opening a new 14 bed inpatient ward for women in the spring this year at Bethlem Hospital."

Prescribing

Throughout the engagement process for the prescribing proposals, Croydon CCG engaged face to face with over 300 individual Croydon residents, patients and professionals at over 30 events, groups or locations.  The CCG received a total of 346 written responses through the online and paper survey.

Dr Tony Brzezicki, Clinical Chair of NHS Croydon CCG said:

"These are very difficult decisions but we need to focus our limited resources where we can have the biggest impact on people's health and well-being.

"Although the response we received to our prescribing proposals was predominantly positive with over 70% of respondents agreeing that the CCG should stop providing self-care medications, we know these changes will cause some people who currently receive these products on prescription difficulty.  We want to work with local communities, Croydon pharmacists and GPs to help make sure we support people to find affordable alternatives and a phased approach to implementation over the coming weeks. 

"As we heard during the engagement period, we share the public's concerns and want to do what we can to prevent these changes impacting on the most vulnerable in our communities.  We are committed to working with local health professionals, community groups and the public to make sure everyone has access to good information to help them find appropriate alternatives to meet their needs.

The full Patient and Public Engagement reports for both engagement processes are published on the CCG's website at www.croydonccg.nhs.uk

Croydon CCG is currently asking local people about their proposal to stop the routine prescribing of IVF.  To find out more and respond to the consultation, which ends on Wednesday 1 March 2017, go to www.croydonccg.nhs.uk