Ministers have been urged to sort out the ‘mess’ of the NHS STPs (sustainability and transformation plans) after BMA analysis found they must slash £26bn from health and social care costs in five years.
The savings figures were found in papers from the 44 areas across England.
Officials in each area have been asked by NHS England to predict the financial holes STPs face in their budgets in 2021 and set out how they can close them.
A separate survey by the association reveals that most doctors (64 per cent) had not been consulted on STPs, despite many plans requiring significant changes to services to balance their books.
BMA council chair Mark Porter said he had serious concerns about the ‘impossible’ scale of savings demanded by STPs by an ‘unrealistic Government’ which had promised no further funding.
‘Improving patient care must be the number-one priority of these plans,’ Dr Porter added. ‘There is a real risk that these transformation plans will be used as a cover for delivering cuts, starving services of resources and patients of vital care.’
Dr Porter added that it was ‘extremely concerning’ that most doctors have not been asked about their STPs.
‘The STP planning process has turned into a mess. It is crucial that any plans about the future of the NHS must be drawn up in an open and transparent way and have the support and involvement of clinicians and the public from the outset. They have the potential to generate more collaboration and the long-term planning of services based on local need.’
The BMA is to keep tabs on the content of each STP over the next few months and is calling on ministers to meet five key demands:
- Plans must be made public as soon as possible
- Proposals in STPs should be realistic and evidence-based
- A commitment to full consultation with clinicians, patients and the public on any proposed changes as soon as possible
- Plans must be properly funded
- Patient care – not savings – must be priority of each and every plan.
Doctors’ warnings about STPs join a growing list from other health experts and local authority leaders.
The King’s Fund last week warned that STPs were at risk of failure because doctors have been largely excluded from consultations.
The Nuffield Trust has said some involved in STPs compared the creation of their footprints with the ‘British dividing up the Middle East, just putting the lines on the maps’.
NHS Providers chief executive Chris Hopson told members of the Commons health select committee last month that unprecedented financial deficits faced by many hospitals risked ‘blowing up’ STPs.
Even NHSI (NHS Improvement), which oversees foundation and other NHS trusts, has raised concerns about its ‘extremely challenging’ timetable for checking STPs before they are rolled out next year.
The analysis found huge funding holes in urban and rural areas of England.
Five STPs, including Greater Manchester, north-west London and Hampshire and the Isle of Wight, face falling into the red by more than £1bn each.
Devon faces a deficit of £557m and Kent and Medway a £485m shortfall in health and social care funding unless its STP is successful.
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