“I WANT the public to have a say on how we spend our £1.2billion health budget.” 

That is the vision of Julia Ross, who said no government will raise tax enough to give the NHS sufficient funding, so tough decisions are needed. 

She is the chief executive at the newly merged Bristol, North Somerset and South Gloucestershire clinical commissioning group (BNSSG CGG), which this week cut funding for gluten-free food prescriptions and expanded options for reconstructive surgery after breast cancer. 

“The public is really anxious about what they see as losing services,” said Mrs Ross.

“It’s about providing something better so you can flow resources to where they need more focus.

“With the best will in the world, no government is going to put tax up enough to give the NHS sufficient resources. We need to do more with what we’ve got.

“One thing I want to do much better is to involve people in the decision making. We have a lot of examples of where we have listened, but I want to involve people in the decisions.

“I want to engage the public in that debate at a local level and say, we have £1.2billion, this is how we spend it.

“If nothing else, it will help people to understand the real challenges we face.”

Explaining the role of the CCG, Mrs Ross said: “The CCG has two functions. We are commissioners – we plan, purchase and monitor healthcare services for our population.

“We have a budget of £1.2billion for the majority of services. It’s our job to make sure we use it effectively.

“We are also the system leader – like the conductor of an orchestra. We oversee providers, a mental health trust, the ambulance service.

“Our job is to make sure all those sections are playing well together to create this beautiful music that meets the needs of our population.”

On that note, it’s worth pointing out that before Mrs Ross entered the NHS she was a music teacher. She made the move in 1988, starting out as an administrator and has worked her way up. She left Surrey for her role in March to lead the newly merged CCG. 

“The merger was essentially a pragmatic move,” said Mrs Ross. “It avoids having to have three different bureaucracies that were already coming together.

“We have stronger leadership and we got a grip on the money.

“When money is in control you can make changes as you want to, you’re free to invest in services. When it’s out of control, all your focus is on saving money. That’s not a good way to be.”

Being able to take control of the budget means the the CCG is able to introduce initiatives like reconstruction surgery for the health breast after a woman has breast cancer.

“We got a lot of feedback from the public and I’m really pleased that we were able to hear that and respond effectively,” said Mrs Ross.

The CCG is also bringing Bristol into line with North Somerset and South Gloucestershire by cutting prescriptions for gluten-free products for adults.

There are likely to be other inconsistencies in healthcare that need ironing out, but different localities have different needs that will continue to be addressed.

North Somerset and South Gloucestershire’s CCGs were rated ‘inadequate’ and Bristol’s as ‘requires improvement’ before the merger.

Mrs Ross said the combined CCG would be rated as ‘requires improvement’ but it has been taken out of special measures, adding: “We are seen to be on the right plan. We have a three-year financial recovery plan. By 2020/21 we will be in financial balance again.

“All the feedback we’ve had is that we’re on the right trajectory.

“My aim is to be rated outstanding. BNSSG CCG should be one of the best in the country.

“You don’t work in the public sector if you don’t have that determination to serve the people. That’s what gets me out of bed every day.

“I see myself as having a huge responsibility in making sure the NHS is here for another 70 years – that it’s able to stand the test of time to provide care for my children and my children’s children.

“I have my own experiences of care, and they weren’t all good. My son has some challenges and hasn’t had a great response to his needs. I’m determined to make services as good as they can be for everyone in our population.”

This summer marks 70 years since the formation of the NHS.

“I think the future of the NHS is bright,” said Mrs Ross. “What’s fabulous is that everybody cares about the NHS. Although there’s a strong political interest, everyone has pride in it. 

“We have some huge challenges. The fact is that demand is growing exponentially. 

“We have an ageing population, and people’s expectations are changing – the younger generation wants everything instantly.

“Medical advances are marching on. We can keep people alive who wouldn’t have survived even 20 years ago. That’s fabulous, but to keep funding it on the public purse is a big demand.

“When you look at social care, money is really challenging. We have to change the way we deliver care.

“We have to do that because we want the NHS to see another 70 years, and more. I want it to be there to support my children, and my children’s children.”