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Millions of patients affected by STPs as new health managers receive ‘eye watering’ salaries

As doctors debate the future of Sustainability and Transformation Plans (STPs) at the BMA’s annual conference in Bournemouth this week, new BMA analysis finds:

  • £8.5m salary bill for new health managers delivering STPs

  • £1.1m spent on private consultancy firms and agency staff

  • Millions of patients could be affected by hospital and A&E closures and bed losses

  • Vast differences in STP process across country


New figures[1], obtained by the BMA through Freedom of Information requests, reveal that more than 150 jobs, including operations managers, communications executives, administrators and financial analysts, with combined annual salaries of at least £8.5 million, have been created to deliver Sustainability and Transformation plans (STPs).

The actual numbers are likely to be much higher, with only around half of the 44 STP footprints responding to the request and others unable to give detail of remuneration for some staff.

Some of the STP areas advertised jobs for agency staff or private consultants, with at least £1.1 million being spent on external firms. Just five areas accounted for more than £5.5 million of the spending:

  • Cambridgeshire and Peterborough created 28 job roles at a cost of £893,000 annually

  • Milton Keynes, Bedfordshire and Luton created 12 jobs at a cost of £920,000

  • North Central London created 19 job roles at a cost of £974,000

  • Leicestershire and Rutland created 22 job roles at a cost of £673,000

  • North East London created 37 job roles at a cost of £2.3 million


The investigation has also revealed a major disparity in the processes being carried out across the country. In some areas, like Lincolnshire, health leaders said they were using the resources already at their disposal to move the STP process forward – but in others, like North East London which has employed 37 staff, whole ‘project management teams’ have been created.

These figures come alongside a new report[2] on STPs published today by the BMA, analysing all 44 STP plans. The report finds that:

  • 17.6 million patients could be affected by hospitals closing or merging (including both community and acute care);

  • 22.9 million patients could be affected by A&Es closing or downgrading;

  • 14.7 million patients could be affected by acute bed closures;

  • 6.6 million patients could be affected by community bed closures.


The report also found that:

  • There has been a poor engagement with clinicians, patients and the public considering the scale of patients affected;

  • Rushed timelines and the scale of the financial challenge mean that plans are being implemented without the appropriate evidence;

  • The upfront funding needed for to deliver plans has not been provided;

  • The scale of the cuts that need to be delivered by STPs will have a worrying effect on patients.


Previous BMA research has found that the 44 STPs will have to make at least £26 billion in cuts to keep inside the public funding constraints set by the Government[3] and that the plans require at least £9.5 billion of capital funding but NHS leaders are unlikely to have anything like the capital required to deliver the projects[4].

The BMA has serious concerns with how STPs have been put together and the way that the overall process has been run. At the end of last year, the BMA asked for the plans to be published as soon as possible, with public and professional consultation on any proposed changes, for all plans to be realistic and evidenced based, for the plans to be funded appropriately to ensure they can deliver what has been promised and for patient care to be the priority for each and every plan, rather than cuts.

Six months on, the BMA does not think that these asks have been adequately met, with rushed timelines indicating that plans are being implemented without appropriate evidence, a lack of engagement with the public, patients and staff and without the necessary upfront funding to successfully carry out any real transformation.

Commenting, BMA council chair, Dr Mark Porter, said:

“Millions of patients will be affected by hospital and bed closures under these so-called ‘transformation plans’, which are a cover for delivering £26bn in cuts to health and social care. It makes no sense to spend this kind of money on staffing and structure when we already know there is a huge shortfall in capital funding needed to actually put the plans in place. Any money spent here runs the risk of being completely wasted.

“With the NHS at breaking point, doctors and patients will be horrified to see millions being spent on another layer of bureaucracy to deliver these controversial plans. The NHS needs more GPs, junior doctors and consultants - there is nothing sustainable or transformational about creating another costly team of managers while staff on the frontline struggle and patients suffer as a result.

“From its very beginning this process was carried out largely behind closed doors, by rushed health and social care leaders trying to develop impossible plans without the necessary funding.

“Some of these STPs seem to be ballooning into new health and social care structures with no mention in law and no proper governance – making a mockery of the top-down reorganisation forced on the NHS in 2012.

“This analysis casts serious doubt on these plans. Doctors and patients deserve a properly funded, transparent health service with patient care not cost cutting at its core.”


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

  1. The data tables are attached to this press release

  2. The paper ‘Delivery costs extra: can STPs survive without the funding they need?’ can be found here.

  3. https://www.bma.org.uk/news/2017/january/hospitals-and-social-care-face-budget-cuts-of-twenty-six-billion-pounds

  4. https://www.bma.org.uk/news/2017/february/nhs-needs-9-5-to-transform

  5. To contact the BMA media office please call 020 7383 6448 or email [email protected]





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