Tag Archives: Sustainability and Transformation Plans

A seminar on Sustainability &Transformation Partnerships in London, held at the King’s Fund on September 12th, voiced the most serious concerns yet from within the political elite about the viability of STPs. As I understood it the King’s Fund’s report contained seven warnings (as well as a job description for a London Mayor with an interest in the NHS). The warnings were: Providing more community-based care is right but the NHS needed to be realistic about what could be achieved in a short time with limited resources. The expected impact of new models of care on hospital use should not […]
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How Simon Stevens imposed a reorganisation designed for transnational capitalism on England’s NHS. Recently shadow health secretary Jonathan Ashworth said his first job in government would be to launch an independent review of every single Sustainability and Transformation Plan (STP) and to halt service closures. He said plans for service changes had “been decided behind closed doors, with no genuine involvement of local people.” In response Health Secretary Jeremy Hunt said, ‘These local plans are developed by local doctors and communities, backed by the top doctors and nurses of the NHS.” Both can’t be right, and indeed casting the net […]
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A possible unwanted side effect of this most avoidable of unnecessary general elections, and the accompanying purdah into which everyone has slumped, is the impact on the NHS reforms initiated by the NHS Five Year Forward View published in 2014 and its update in the Next Steps delivery plan published last month. One can only hope the NHS Chief Executive, Simon Stevens, is correct when he asserts that ‘there is no version of reality’ in which his changes will not be needed and actively pursued. Even if he is proved right there could still be disruption if a new health […]
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Late last year, Sustainability and Transformation Plans (STPs) were adopted in each of 44 areas covering England. Nationally, the plans seek to cut annual NHS spending by £22bn, by 2020/21. This aim was set out in 2014 by NHS England Chief Executive Simon Stevens in the Five Year Forward View, never properly debated. Stevens is a former health manager, Labour Councillor, advisor to Tony Blair and executive vice president of UnitedHealth Group, one of the biggest US private healthcare corporations. £22bn is the gap between the predicted increase of £30bn required to maintain NHS services, and the Govt offer of […]
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  I feel passionately about the NHS. It is something we as a nation should be immensely proud of, and we are lucky we established it when we did, because I expect it would be very difficult to set up such a scheme now with all the vested interests who would oppose it. It stands as a symbol of fairness and solidarity in a society which is otherwise becoming more unequal and fractured. I am involved with the NHS and I never cease to be amazed by how selfless and ethical most of the people who work in it are. […]
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Jeremy Hunt’s STPs – the sustainability and transformation plans – are”a massive top down reorganisation that is destroying England’s national health service. Slash, Trash and Privatise is what the letters really stand for.  Hunt and his cheerleader Simon Stevens (director of NHS England) are getting away with murder. Even Margaret Thatcher didn’t dare to attack the NHS in the way they are doing. They are breaking up our shared national service and putting it out to tender – this week Manchester put £6 billion of our NHS on the open market. They deliberately did this before the May elections to […]
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To implement STPs fully, the NHS will have to be transformed. From what we know about organisations that have transformed themselves, is the NHS capable of this? Viewed from a systems perspective, the NHS is perfectly designed to achieve what it achieves: an (imperfect) reconciliation of competing goals. There is explicit and implicit conflict built into the design of the NHS system. For example, it is a national service yet encourages commissioning/postcode variation; it is publicly-funded and pursues PFI and privatisation; it manages a fixed budget unrelated to demand and yet runs deficits; and it offers a bottom-up vision but […]
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The Sustainability & Transformation Plans are running out of steam, thanks to the Government’s squeeze on NHS finances. An attempt to think about how to develop a better and sustainable care system has turned into a financial rescue plan for hospitals. At the end of March STPs will be “refreshed” but it is hard to have much confidence in the outcome. The NHS may simply default to its standard operating procedures. Anticipating this Don Redding, of the charities’ coalition ‘National Voices’, has argued in a Health Services Journal article about STPs that the current problems of the NHS will not be […]
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STPs are loose coalitions of agencies without statutory powers, so they cannot implement change, only encourage it. With little money left in the Transformation Fund, they have to “work around” their local NHS and social care organisations. At the launch of the King’s Fund report ‘Delivering sustainability and transformation plans: from ambitious proposals to credible plans’ (on 21st February) we heard that “with the right leadership” STPs could stabilise the NHS, that STPs mean that “politicians must be brave” (and not impede changes in the NHS in their constituencies), that NHSE and NHSI need to work as one (because they […]
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Staffordshire was the last of the Sustainability and  Transformation Plans to be published perhaps because relationships in this part of the country are rumoured to be poor. Both providers and commissioners in the area are challenged. Despite this the commissioners in Staffordshire are going ahead with a hugely controversial project to outsource some £1.2 bn of NHS services. This is at least in part an outsourcing of commissioning functions. The Public Accounts Committee considered a similar exercise in Cambridge with some grave concerns. The PAC report into the matter noted:- We asked the CCG why it had decided to contract […]
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The Department of Health (DH) is to create a new property company to replace the two that currently exist1 nearly four years after the intention was first announced. The move is understood to be one of the recommendations of Sir Robert Naylor’s forthcoming report on the NHS estate. The current position came into being as an afterthought to the now much derided Health and Social Care Act 2012 “reforms”, with a new DH owned company, Propco, solving the problem of who took over billions of pounds of property (such as primary care centres, clinics, community hospitals and offices) after Primary […]
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Many members of the public, and even some politicians, are only just becoming aware of Sustainability and Transformation Plans, which were imposed in a policy directive from NHS England just 3 days before Christmas in 2015 as part of a major shake-up of the NHS. The dramatic reorganisation of England’s NHS into 44 ‘footprint’ areas, and the requirement for all NHS bodies to collaborate with local government social service agencies on these new 5-year plans, seemed like NHS England’s best hope of balancing its budgets by 2020-21. But the variegated and inconsistent series of 44 documents that have been published […]
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