A DOCTORS' group is considering stopping providing patients with over the counter medicines, withdrawing services and pressing self-care, as it battles an £8.4m budget shortfall.

Harrogate and Rural District Clinical Commissioning Group (CCG), which consists of 17 GP practices in the Ripon, Knaresborough, Boroughbridge and Harrogate areas, said it was reviewing all areas of its spending, including the services it purchases, medicines prescribed, outpatient appointments and operations.

The CCG said it had plans in place to overcome the multi-million pound shortfall this financial year, but with costs continuing to rise, it was preparing further changes in its spending to bridge the budget gap.

The announcement is likely to come as shock to many as the body which commissions NHS services was last month rated as outstanding by NHS England in its year-end assessment placing the organisation in the top ten out of 211 CCGs nationally.

It unveiled the proposals, which will see a "renewed focus on self-care and healthy lifestyle choices by individuals and may include reduction or withdrawal of certain services that do not improve outcomes", as it revealed many of its neighbouring CCGs were also facing "unprecedented challenges", as demand from an ageing and growing population increases.

The CCG said as money was allocated to it from the Government based on the size of the population it had found its budget was stretched further as demand for healthcare increased.

There have been long-standing concerns among health campaigners in North Yorkshire over the amount of funding for NHS services in the county, which is lower per head than in some neighbouring cities due to its perceived low level of deprivation, while it has a higher than average and rising elderly population.

It has been estimated that more than 40 per cent of NHS spending is devoted to people aged over 65 and that an 85-year-old man costs the NHS about seven times more on average than a man in his late 30s.

The CCG has moved to illustrate its financial plight by revealing that from April to June last year and over the same three months this year, the number of people attending accident and emergency increased by 2.7 per cent, equating to an additional £125,000 cost that had not been planned for.

The same periods saw a 14 per cent increase in the number of knee procedures, at an additional cost of £160,000.

The CCG said while over the counter medicines cost it £260,000 to prescribe last year, paracetamol and other painkillers were widely available in supermarkets and chemists and cost around 1p per tablet, compared to 3p per tablet on the NHS.

In response to the budget pressure, it has launched a review of "every service it commissions" to identify how its funds can be best spent and will consult residents about their views on where demand can be reduced and costs curtailed.

Rick Sweeney, a governing body member of the CCG, said: “Getting medicine on prescription costs much more than buying over the counter due to the time doctors and local pharmacists take when dealing with appointments, handling prescriptions and dispensing medication. Last year, more than three million items were prescribed to patients across Harrogate and the rural district at a cost of over £25m.”

Amanda Bloor, chief officer of the CCG, said the changes would focus on ensuring taxpayers received value for money.

She said: “It is important that everyone using the NHS appreciates the pressures it faces through growing demand and cost and takes responsibility for using it most effectively so we can help secure high quality local health services.

"Everyone is aware that public services and specifically the NHS are under significant pressure, and I would encourage local people to help the CCG ensure we can continue to deliver the services needed for local people within the budget we are given from Government.

“We will be working closely with our partners including Healthwatch North Yorkshire to determine how we can secure services within the funding available.”