Fit for the few – The Sustainability and Transformation Plan (STP) for the Cambridgeshire and Peterborough NHS footprint was published on 21 November 2016,1 as the keystone of the Fit for the Future programme. The plan reveals the scale of the deficit that is being created in the local NHS by the austerity imposed by Conservative and Conservative-led governments since 2010, which will amount to £504m by 2020/21. And it shows the narrow paths down which that strategic underfunding – or defunding – is forcing the health service.
The Sustainability and Transformation Plans: a critical assessment. John Lister, January 2017
Letters to the Cambridge Health (Scrutiny) committee
Fit for the Future is the official CCG website related to the Cambridgeshire and Peterborough STP.
Sustainability and Transformation Plan (STP) published 21 November 2016
Stevens: STPs will get ‘decision rights’ to reorganise trusts and CCGs
HSJ, 9 FEBRUARY, 2017
- STPs to be given right to “recommend” member trusts and commissioners reorganise
- STPs should act if “veto power or inertia is getting in the way of the bigger strategic change agenda”, Simon Stevens says
- NHS England chief also says new forward view update plan is not “not a funding bid”
STPs: a new way to carry through cuts
From Health Campaigns Together newspaper No 3, summer 2016 (excerpt)
Since January England’s NHS has been carved up into 44 footprint” areas, in which commissioners and poviders are supposed to collaborate together. That mght appear to be good news, if the complex, costly and divisive competitive market system entrenched by Andrew Lansley’s Health & Social Care Act was being swept away, and a new, re-integrated NHS was empowered to work together again to improve services.
But that’s very much NOT the case: instead the main task of the “footprint” areas is to balance the books of each “local health economy” – taking drastic steps where necessary to wipe out £2.7 billion of deficits built up by trusts last year. Each area has to draw up a 5-year Sustainability & Transformation Plan (STP), to be vetted by NHS England. And while they do so, all of the legislation compelling local CCGs to open up services to “any qualified provider” or put them out to tender remains in full force. The private sector is still snapping up contracts. The rule book has been torn up, legislation somehow avoided, and a coup launched led by NHS England chief executive Simon Stevens.
Stevens is the man who urged Tony Blair’s government to experiment with private sector providers for the NHS, and then spent nine years at the top of US health insurance giant UnitedHealth. So we have reasons to mistrust what is taking shape now. The 44 leaders appointed by Stevens to lead planning in the “footprint” areas are to be:
– given powers to override the checks and balances within the legislation, with minimal consultation
– encouraged to overcome the “veto powers” of individual organisations to stand in the way of controversial changes
– forcing decisions on the disposition of hospital services. The detail is yet to be revealed and the plans of most of the 44 have not been made public, but we know enough to predict [Many of our predictions have now been confirmed by a Health Service Journal survey of 99 CCGs.]:
– Many A&E departments, urgent care units and hospitals will be closed or significantly downsized
– Hospital capacity will be significantly reduced in return for promises of investment in “care in the community”
– The priority in the NHS will be the capping of budgets and eradication of deficits
– This will be achieved by restricting access to healthcare, cutting capacity and reducing staff
– Due process enforcing rational decision making will be set aside to ensure decisions are made in support of these plans, without any delay.
Glut of NHS closures ahead warn hospital chiefs
CCGs’ Planned or likely changes to NHS services
Closing or downgrading of community hospitals
Losing urgent care centre or similar
Overall reduction in hospital beds
Reduction in staff in acute services
Closing of Downgrading full A&E
One or more hospital to end consultant-led maternity
SOURCE: HEALTH SERVICE JOURNAL, SURVEY OF CCG CHAIRMAN AND ACCOUNTABLE OFFICERS
Cited in the Daily Telegraph, 31 October, 2016