STPs Heralded as New Round of NHS Cuts

It was revealed last week that plans are being drawn up to identify which NHS services can be cut across England. The country has been split into 44 areas by NHS England, and health and social care representatives from each have been asked to submit a cost-cutting ‘sustainability and transformation plan’ (STP).

The STPs have identified potential savings from cutbacks, mergers and changes across the whole NHS to help tackle the financial shortfall of £20bn that is predicted by 2020-21.

Reports suggest general practice will be hit by the planned changes, with surgeries in Leicestershire and Rutland potentially being put ‘under review’ because of funding shortages. Other plans include reducing face-to-face patient care through the use of more ‘virtual consultations’ and coaching that will be introduced to help patients manage their own health. These cuts may receive the green light as soon as this autumn.

38 Degrees, a crowdfunded campaign group, uncovered many more STP reports from across the country, including proposals for A&E closures in the Black Country, ward closures at Leeds Teaching Hospitals Trust and the closure of acute hospital services in Leicestershire. A possible "major reconfiguration" of frontline NHS services in Wakefield and North Kirklees, as well as Calderdale and Huddersfield, was also highlighted.

FPM’s Content Manager Survindar Chahal shared his opinion: “When the Five Year Forward View was published in 2015, it was lauded as an acceptance within the NHS that something had to be done to drive improvement in healthcare. Last year, the government promised an extra £8bn a year for patient care from new or existing budgets, but the overwhelming feeling is that they’ve given with one hand and are now taking with the other.

“There needs to be efficiencies, but in the right places – better procurement of goods and services in the bigger NHS organisations, for example. Practices are already saying that they have come to the end of the line with cutting costs, and it looks like there are more plans up and down the country looking at how to squeeze even more out of practices that have already been under pressure.”

These controversial leaks have once again put Jeremy Hunt and the DoH back in the spotlight and in line for fresh criticism after the junior doctor strikes that hit the news earlier in the year. However, an NHS spokesman told Sky News last week that changes would only happen “where they are designed by doctors and in the clear interest of patients”.

What is an STP?

• Sustainability and Transformation Plans are five-year plans to cover NHS spending in England.

• There are 44 geographical ‘footprint areas’ led by key figures from CCGs and NHS Trusts, along with some led by local government. You can see them here.

• There are questions for local leaders to consider in their STPs covering three key areas:
   o Improving quality and developing new models of care
   o Improving health and wellbeing
   o Improving efficiency of services

• Leaders will identify key priorities for their areas to meet local health challenges and to meet financial targets. The list of STP leaders is available on the NHS England website.

• STPs are also tasked with looking at how to provide better integration with local authority services.

We’ve been discussing these potential cuts, STPs and the Five Year Forward View in the new FPM Forum – why not join the conversation and tell us how you think this could affect your practice?


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