NHS: Radical changes on the table from STPs

Health service under pressure to deliver step change quickly

26/08/2016

Michael Boyd

Michael Boyd

Partner

Commenting on reports of proposed cuts to NHS services contained in draft Sustainability and Transformation Plans (STPs), healthcare partner Michael Boyd said:

"Given the difficulties faced by the NHS it is inevitable that radical changes have been considered as part of the STP process.  We should also remember that participants were encouraged to be bold when considering options that should be put on the table.  STPs represent a set of possibilities and options.  They do not amount to concrete plans which will be implemented come what may, although they will be a clear indication of the preferred way ahead supported by the participants across the STP area in terms of being able to cope with the options outlined.

“The fact that these possibilities have been contemplated does not obviate the need to undergo a statutory consultation process before any of these plans are implemented and we know from recent history (Lewisham A&E) and current activity (Calderdale) how lengthy and difficult these consultations are and that a closure outcome is often very difficult to achieve.

“Although transformation cash will be helpful in the short term, the amount of that cash that has gone to address deficit situations means that only a part of the available fund will be available to implement the proposals made in the STPs.  It is also clear that the NHS will continue to run a deficit for a considerable period - a spiral of decline, the speed of which will be influenced by the extent to which savings and efficiencies can be secured through implementing STPs.

“The problem is that the NHS needs to deliver step change quickly but apart from relatively small victories which can be delivered relatively easily, the big stuff is some way off.  Twas always thus. Central support for the NHS is key.  The recent changes at Government level are likely to lead to a closer evaluation of the progress made in achieving the efficiencies at the heart of the 5 year forward view.  Failure by STPs to deliver may mean that previous attitudes to the NHS change and a harsher regime is imposed.  This is probably the last thing the NHS needs.

“In terms of saving the NHS, we should acknowledge the achievement made by the STP process and its participants in identifying challenging options.  However, we should also acknowledge that additional time is required to turn these plans into reality."

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