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STPs 'undeliverable', says NHS Providers chief

Many STPs (sustainability and transformation plans) are undeliverable owing to the speed and way trusts have to plan, MPs have been warned.

NHS Providers chief executive Chris Hopson told members of the Commons health select committee on 11 October that time constraints and the unprecedented financial deficits facing trusts risked ‘blowing up’ the schemes.

Mr Hopson said that, though he felt STPs had a lot of potential to increase integration between health and social care services at regional levels, the speed with which trusts were being required to develop plans was proving detrimental.

He said that health providers were being further burdened with having to design plans that would be able to fit with future budget constraints in years ahead, and that the approach threatened to derail STPs’ potential benefits.

He said: ‘They [health providers] are now required to meet a 2020/21 financial allocation. The funding is going to drop, so they're now looking at a set of figures that, to be frank, just look completely undeliverable.

‘Our members are saying to us that they are spending quite a lot of time creating plans that in their view are not deliverable and usually involve major structural service changes, because that is the only way where they can create a balanced plan.’

Mr Hopson’s comments came during a parliamentary evidence session in to the state of NHS finances, which was also attended by NHS Clinical Commissioners chief executive Julie Wood and former health secretary and NHS Confederation chair Stephen Dorrell.


Rampant deficit

Asked by Labour MP for Dewsbury Paula Sherriff to give an overview of provider sector’s finances, Mr Hopson stated that levels of deficit were ‘unprecedented’.

He said: ‘It's not just a few providers running up big deficits – you've got more than 65 per cent of the entire sector in deficit and more than 80 per cent of acute hospitals in deficit.

‘What really worries [us] is if you look at the funding increases that are coming over the next few years.

'As cost and demand rises in the NHS by 4 per cent a year, we're going from a 3.7 per cent increase this year to a 1.3 per cent increase next year and 0.3 per cent the year after.’

The committee also took evidence from National Audit Office comptroller and auditor general Sir Amyas Morse who suggested that Government-imposed efficiency targets had been applied for too long and, in some cases, harmed trusts.

He said: ‘Over the last [few] years there have been aggressive efficiency targets in the NHS. I am sure they have produced some efficiencies, but they are also the reason why, or one of the biggest reasons why, so many NHS trusts have found themselves in deficit. 

‘If you say "we're going to have a 4 per cent efficiency target" that's a lot. In a relatively low-growth economy [this level] of efficiency [is] mostly not delivered, it had a very significant effect on the environment.

He added: ‘Having furniture that you put in place that seemed like a good idea at the time, still years later you've got it there, I think you need to revisit all of it and say is this really helpful?’

The committee’s next evidence session into NHS finances, which will be attended by health secretary Jeremy Hunt, will take place on 18 October.

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