NHS leaders will pick and choose which STP (sustainability and transformation plan) projects will actually be implemented – with too little cash available for all changes to be made.
An NHS England board document reveals that ‘capital is very tight over the next few years’ and health managers will have to identify which changes are ‘essential for unlocking improvements and efficiencies'.
The report says an investigation of the benefits to patients and return on investment will now begin with those projects which are ‘shovel ready’ will be focused on.
All 44 STP footprint areas have now published their plans and earlier this month the BMA revealed that the projects will have to make savings of £26bn between health and social care in total in the next five years.
BMA council chair Mark Porter said: ‘The production and publication of STPs has followed a deeply flawed, and rushed, process mired in secrecy and the professionals expected to deliver these changes on the frontline have often had little or no involvement.
‘This document clearly reveals what we have been saying for some months now – that these plans cannot work without proper capital investment up front and genuine clinical engagement.
'It appears neither of these things are in place and unless that changes the process will simply be another pointless, painful and costly top-down NHS reorganisation.
‘The Government must take stock and consider its funding of the NHS. Not only are staff exhausted and demoralised on the frontline but they are being asked to deliver world-class care with second-class resources.
‘STPs appear to be more influenced by the need to make another £26bn of savings than improving the availability of healthcare services, and so risk making these deep, painful problems much worse.’
According to the report, which went before the NHS England board on Thursday, STPs are now turning their efforts toward implementation, with regional teams from the national health body set up to support each area.
The NHS England teams will look to ensure that a ‘minimum infrastructure’ – which could include particular staffing plans, a finance function and a team to lead local engagement – is in place in each area.
The document says: ‘The next step is to make STPs real through two-year operational plans and to complete the contracting round by 23 December.
'By agreeing contracts early and quickly, we have an opportunity to cut through the traditional process. This will enable us to move into the New Year with a practical focus on implementation.’
It adds: ‘Capital is very tight over the next few years; STPs’ requests exceed what is available. This review will identify strategic schemes that are essential for unlocking local improvements and efficiencies.
'To support strategic schemes, we will need to understand the benefit to patients, including return on investment, when they will pay back and expected clinical benefits. We will also want to focus on those that are “shovel ready”.’
It comes just a week after the BMA revealed that two-thirds of doctors have seen no clinical or public engagement on STPs.
Results from the association’s latest quarterly survey revealed that 64 per cent of doctors said they had witnessed no engagement on the STP process in their area, despite expectations that all 44 plans would be published by the end of 2016.
The findings also showed that while seven out of 10 doctors are aware of STPs only one in 10 supported their introduction, with six in 10 unsure of their position.
Read the NHS England board document
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