STP AND OUR LOCAL NHS
STP is the govt imposed implementation of Simon Stevens chair of NHS England’s 5 year forward view. 44 specially created STP regions controlled by Boards across England have been created by the government and given unprecedented powers despite the fact they have no legal status (by govt admission) no public accountability or oversight. STPlans have been put together in total secret. All are now in the public domain but many with woefully little detail about what is being proposed. NHS England has recently given STP boards much greater powers to veto and over-ride any opposition from Local Authorities or NHS bodies.
The supposed major aims of STP are to integrate health and social care; to create collaboration rather than competition; to streamline health and social care pathways.
THE STING IN THE STP TAIL :
HOSPITAL SERVICES AND DEPARTMENTS – NOTHING YET PUBLISHED FOR THIS REGION
According to recent i-news – across England under STP:
PROPOSED OR LIKELY CLOSURE OF 19 HOSPITALS
CLOSURE OF MORE THAN 2000 BEDS IN COMMUNITY AND ACUTE HOSPITALS
LOSS OF NEARLY 3000 JOBS and much more ……
Not all plans have been released in full and these figures under-play the true gravity. List so far on website - https://inews.co.uk/nhs/nhs-crisis-19-hospitals-face-axe-as-doctors-accuse-government-of-deliberate-underfunding/
NHS England has specified (Keogh report) that the aim is to reduce the number of fully operational A&E’s across England to one per STP footprint ie 44.
- 40% reduction in emergency admissions to hospital of people over 75
STP is the govt imposed implementation of Simon Stevens chair of NHS England’s 5 year forward view. 44 specially created STP regions controlled by Boards across England have been created by the government and given unprecedented powers despite the fact they have no legal status (by govt admission) no public accountability or oversight. STPlans have been put together in total secret. All are now in the public domain but many with woefully little detail about what is being proposed. NHS England has recently given STP boards much greater powers to veto and over-ride any opposition from Local Authorities or NHS bodies.
The supposed major aims of STP are to integrate health and social care; to create collaboration rather than competition; to streamline health and social care pathways.
THE STING IN THE STP TAIL :
- NHS England has imposed “savings” ie cuts of £22 billion on the NHS in England by 2020/21. The govt is getting rid of its responsibility for the dire financial situation of the NHS (which it has brought about) – pushing it on to the 44 STP regions.
- In the (“work in progress”) plan released so far our region (so-called footprint 33 of 44 – West and East Sussex and East Surrey) has to cut a staggering £864 MILLION by 2020/21.
HOSPITAL SERVICES AND DEPARTMENTS – NOTHING YET PUBLISHED FOR THIS REGION
According to recent i-news – across England under STP:
PROPOSED OR LIKELY CLOSURE OF 19 HOSPITALS
CLOSURE OF MORE THAN 2000 BEDS IN COMMUNITY AND ACUTE HOSPITALS
LOSS OF NEARLY 3000 JOBS and much more ……
Not all plans have been released in full and these figures under-play the true gravity. List so far on website - https://inews.co.uk/nhs/nhs-crisis-19-hospitals-face-axe-as-doctors-accuse-government-of-deliberate-underfunding/
NHS England has specified (Keogh report) that the aim is to reduce the number of fully operational A&E’s across England to one per STP footprint ie 44.
- 3 NHS trusts in this region are in “special measures” BSUHT for quality and finance. East Sussex Trust and the South East Ambulance Trust. NHS Improvement national officers and private consultants are currently deciding what will happen to hospitals in the region, what will happen to the Royal Sussex and other A&Es and maternity services.
- The first change introduced by NHSImprovement was a “buddying arrangement” between Western Sussex and BSUHT for three years. The current Chief exec of BSUHT, executive board members and some senior managers are being replaced. This is a takeover. We need to know what is happening?
- The Royal Sussex is designated a SE regional trauma hub. Its priorities are the 3 T’s (Trauma, Tertiary and Training).
- According to a senior local NHS commissioning officer - 50% of local patients are treated in hospitals other than the Royal Sussex, often outside the city. With the likely future traffic in trauma patients from the region serious questions have to be asked about the future role of the Royal Sussex as a general hospital.
- CUTS IN NHS STAFFING Two divergent figures are quoted in the draft STPlan for “savings” - “Provider Productivity” - £276 million and £340 million in “Productivity change”. Whichever figure is correct, it can only mean substantial staff redundancies; accelerating of the down-grading of bandings and posts (well under way); de-skilling (nursery nurses replacing community nurses, physician assts to replace some GP functions etc); the dismantling of AFC conditions and contracts; transfer of many more NHS staff to the private sector.
- OTHER CUTS SPECIFIED IN OUR REGIONAL REPORTS (SO FAR) SOCIAL CARE - £112 MILLION; PLACE-BASED ACUTE CARE- £171 MILLION; “ PREVENTION” a supposed cornerstone of STP - £29 MILLION.
- THE PLACE-BASED DELIVERY PLAN (which covers BnH - one of three in the region) AND IMPLICATIONS FOR PUBLIC HEALTH
- 40% reduction in emergency admissions to hospital of people over 75
- 50% reduction in “excess (hospital bed) days for over 75s” to be placed according to the draft report in an “alternative setting”
- GPs to save £47.4 million by “managing” patient referrals to hospital “better”
- NEW METHODS TO DELIVER STP. Primarily US imports.
- Every region will have an ACO ((Accountable Care Organisation) to run and carry out the development of STP. Some LAs are setting up private SPV (Special Purpose vehicles) to enable them to run ACOs which will be prime targets for corporate takeover.
- Multi-speciality community providers (healthcare hubs providing x-ray facilities, minor injuries etc) form the basis of the single Place-based delivery plan published so far. There are 6 GP clusters in BnH. Will each of these have an MCP? How will these be funded in the face of such massive cuts?
- 7 GP practices in BnH have already closed down forcing many people to travel much further to see their GP – how many more will go?
- PUBLIC ENGAGEMENT AND CONSULTATION The NHS England “Engaging Local People” report stated the need for strictly followed consultation along the lines of the nationally recognized Gunning Principles with a minimum of 12 weeks consultation.
- The report absolves NHSE and STP Boards of legal responsibility for consultation and engagement. All onus placed on individual NHS trusts etc for non-compliance.
- All mention of consultation has disappeared from local and national STP statements.
- USE OF CONSULTANTS IN STP We know KPMG are heavily involved in the development of the Royal Sussex and the 3T’s. Some STP regions have spent in excess of £2million on consultants. We do not know the figure for our region, but intend to find out.
- NATIONAL AND LOCAL OPPOSITION TO STP SPREADING RAPIDLY
- More than 30 Local Authorities round England are opposing STP. Hammersmith and Fulham has initiated legal action.
- Professional orgs including NHS Employers are very vocal about STP being unworkable.
- Unite and PCS national both oppose. Other unions are joining them.
- Demonstrations from Cornwall, Devon to Cumbria – 400 people took over an NHS meeting in Cornwall. Massive Health Campaigns Together and TU demo in London on March 4th. (Tavistock Sq at 12). Trains organised from Brighton. See our website.
- BnH council Health Overview and Scrutiny committee is calling for evidence into STP. If you would like to contribute to this group email defendthenhs@gmail.com
- Parliamentary opposition to these plans is urgently needed. The Labour Party needs to develop their strategy to oppose with all their might and fast.
