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Private firms receive £2.3m to draw up STP plans

Diverse doctors

Private firms have been paid a ‘shocking’ £2.3m to draw up controversial plans which will cut health and social care spending by more than £1bn in a part of London.

According to health leaders drawing up the North Central London STP (sustainability and transformation plan), six-figure sums were paid to eight different companies – including accountants Deloitte and management consultants McKinsey – for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.

A firm called Consultants Methods Advisory Ltd, which describes itself as ‘shaping public services for the digital age’, racked up the biggest costs, invoicing £617,850 for ‘programme management office and strategy support’.

Doctors leaders described the figures as ‘appalling’.

BMA council chair Mark Porter said: ‘While hospitals fall into crisis, social care hits rock bottom and the Government blames hard-working GPs for its political choice to underfund the NHS, every penny of health service money becomes more desperately valuable and doctors will find it galling to see that so much vital resource has been handed to consultancy firms for their part in failing plans which, ultimately, may never come to fruition, while frontline staff struggle to provide safe patient care in a service increasingly becoming unfit for purpose.’

 

Pick and choose

BMA News analysis last year revealed that the STP process – which has seen England divided into 44 ‘footprint’ areas, with each asked to produce a plan to integrate and transform local services – will need to cut some £26bn from their budgets by 2021.

And in December an NHS Improvement board paper revealed that only projects which were ‘shovel ready’ would be likely to be funded – with capital resource too tight to pay for all the projects.

Dr Porter added: ‘NHS Improvement has admitted that it will pick and choose the parts of these vast, bewildering plans it can actually put into action and, as such, it leads me to question whether all of this money handed out to private companies will be completely wasted – yet another example of vital resource being frittered away in a health service devoid of direction and leadership and lurching from one unnecessary crisis to another.’

The North Central London STP – and its final iteration: a 68-page word document in PDF format – aims to combine ‘radical service transformation and incremental improvements’. It reveals that the area faces a funding shortfall of £1.2bn in 2020/21 if spending and funding levels continue as expected.

In the plan, health leaders admit to ‘not having all the answers’ and still expects its NHS organisations to be in the red by £75m in five years – even after all the cuts.

 

'Shocking, disgusting and appalling'

Camden GP and local medical committee chair Farah Jameel said: 'As a practising GP struggling to meet patient needs with ever tighter resources, the words that come to mind when presented with these financial figures are shocking, disgusting, appalling and ultimately not surprising.

'The Government should be held accountable for allowing this inappropriate use of funds and be encouraged to focus attention on addressing the very real challenges affecting those who work in and rely on the NHS.

'We are in the midst of a winter crisis, the NHS has systematically been stripped of much needed resources translating into services performing under extreme pressure and stress, in this context these monies would be much better spent on frontline services like A&E's and General Practice.

'I remain acutely aware of the Government's agenda to transform and reconfigure services to better suit the needs of the population within the constraints of a shrinking financial envelope.

'With that in mind the absence of strong clinical input regarding service capacity and patient need in the planning process is frankly disappointing, especially given the large figures of tax payers' money involved.'

 

A new norm?

In total 17 different firms were paid for their involvement in putting together the STP.

McKinsey and Company were given £360,000 for ‘strategy assessment’ and ‘financial modelling’ particularly related to mental health services and initiatives.

Deloitte LLP was given £257,336 for ‘finance and activity modelling’.

And recruitment specialists Hunter Healthcare Resourcing charged £282,518 for administrative support.

Methods Advisory Ltd did not respond to BMA News’ request for comment. But a column on its website said: ‘We have worked in health and care for over 25 years, with all its incarnations and ambitions.

'This gives us the ability to know what has worked (or not) before, alongside knowing what the potential… [to be] the "new normal” in health and care.’

 

Leaked costs

The revelations come months after a letter was leaked to the BBC revealing the cost of external providers to an STP in Cheshire and Merseyside.

PricewaterhouseCoopers were paid £300,000 – less than a seventh of the total cost in North Central London – to help draw up the Cheshire and Merseyside STP, a plan which requires savings of £999m within five years.

Explaining the costs, Louise Shepherd, lead for the Cheshire and Merseyside STP, said: ‘This is to provide additional capacity and expertise to help and support our clinicians and managers design our future care models while still delivering a very challenging “day job”.’

NHS Improvement and the North Central STP lead have been contacted for comment.

The North Central London patch includes: Barnet, Enfield and Haringey Mental Health NHS Trust; Camden and Islington NHS Foundation Trust; Central and North West London NHS Foundation Trust; Central London Community Health Care NHS Trust; Great Ormond Street Hospital; Moorfields Eye Hospital; North Middlesex University Hospital NHS Trust; Royal Free London NHS Foundation Trust; Royal National Orthopaedic Hospital; Tavistock and Portman NHS Foundation Trust; University College London; and Whittington Hospital.

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