England General practitioner Consultant

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Half of London's doctors haven't heard of STPs, survey finds

More than half of doctors in London have not heard of sustainability and transformation plans (STPs) due to be published by the end of this year, a BMA survey shows. 

Of the 615 consultants and GPs surveyed, a majority (59 per cent)  said they had not heard of STPs - five year plans detailing how areas will work together to implement NHS England’s Five Year Forward View.

The BMA asked GPs and consultants in London about their involvement in the creation of the four STPs footprints for the city, made up of clinical commissioning groups (CCGs), local authorities, NHS trusts and other health and care organisations. 

When asked if doctors felt they could influence decisions made by their clinical commissioning group (CCG), more than four in five (82 per cent) said they did not feel they could, even though CCGs are membership organisations. 

The BMA believes that STPs could provide opportunities for collaboration and longer-term planning, but have concerns that they are an inadequate response to the real crisis, that of the long-term underfunding of patient care.The survey’s findings also raise questions about the involvement of doctors and medical professionals in STPs and a lack of understanding of STPs, which require NHS trusts to be financially balanced by 2020. 

Some of the key findings among the consultants surveyed were: 

•    53 per cent have not heard of STPs
•    85 per cent have not had any information about STPs from their Trust
•    88 per cent felt they were unable to influence decisions made by their CCG
•    93 per cent felt they have not had enough information about how health services are being devolved in pilot areas
•    73 per cent do not know if devolution is happening in their area

 Some of the key findings among London’s GPs were: 

•    66 per cent have not heard of STPs
•    87 per cent were not formally consulted about the STP
•    76 per cent felt they were unable to influence decisions made by their CCG
•    61 per cent did not know how to challenge or change the leadership of their CCG

Commenting on the findings, Dr Gary Marlowe, BMA London regional council chair, said:

“Local authorities in London including Camden1 and Sutton2 councils have felt they must publish their draft STP documents because of the lack of public, patient and political involvement and full transparency. The realities of no clear vision for health and social care in London are setting in, with one in five London GP surgeries facing closure in the next three years3 and several London NHS trusts have been placed in special measures4.

“It is extremely concerning that more than half of doctors surveyed didn’t know about STPs. Of those who are aware, many are concerned this is merely a means of delivering cuts to NHS services, though some others see this as an opportunity for localised long-term strategic planning in health. 

“The difficulty is that doctors haven’t been told enough about STPs to fully understand their impact and to decide if their concerns have been addressed. 

"As we’ve seen in the debate over NHS funding in recent days, many services are at risk of financial collapse and meaningful input into STPs from clinicians, who understand what is happening on the front line, is essential. 

“The BMA is encouraging doctors to seek contact with their STP lead and to find out more about what’s happening locally but NHS providers, CCGs, local authorities and other health and care services must work harder to engage medical professionals if they are seeking support for their efforts.” 


Notes to Editors 

The British Medical Association (BMA) is the voice of doctors and medical students in the UK. It is an apolitical professional organisation and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of care.

London GP survey on STPs - Total respondents: 277


Have you heard of STPS?


Did your CCG formally consult you about the STP (plan)?


CCGs are membership organisations – do you feel you are able to influence decisions made by your CCG?


If you are unhappy with your CCG do you know how to challenge or change its leadership?

 Yes 33% 13% 24% 39%
 No  67% 87% 76% 61%


London Consultants survey on STPs - Total respondents: 338


Have you heard of STPs?


Has your Trust given you any information about the STP (plan)?


CCGs are membership organisations, do you feel that you are able to influence decisions made by your CCG?

Health services are currently being devolved by the Government in pilot areas. Have you had enough information to understand what that means?


Is devolution of health services happening in your area?

 Yes  47%  15%  12%  8%  17%
 No  53%  85%  89%  92%  10%
 Don't know
 n/a  n/a  n/a  n/a  73%


2 https://www.sutton.gov.uk/info/200333/adult_health_and_social_care/1586/sw_london_sustainability_and_transformation_plan_stp




For further information please contact:

British Medical Association, BMA House, Tavistock Square, London, WC1H 9JP
Telephone: 020 7383 6448 
Email: [email protected]
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