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The damaging consequences of STPs

Hard-wired GP

Luke Koupparis

Tuesday, 28 February 2017

NHS_shutterstock_393927661.jpgFinally, there is a suggestion that MPs are understanding that Sustainability and Transformation Plans (STPs) are a cover to significant cuts to the budget and services and not an improvement in health and social care. The House of Commons Public Accounts Committee (PAC) has raised serious concerns about the local STPs and suggested that there will be damaging consequences to patient care by these repeated “raids” on funds designed to meet daily funding requirements. All STPs describe plans to close gaps in NHS finances – a theme that has become more prominent as the STP process has progressed.

Many GPs have been concerned about STPs and have been voicing their concerns since the autumn of 2016. The plans seem to be built on the premise that hospitals are too busy to cope and this work can be transferred into the community with no additional funding. In order to release demand in primary care it is suggested that GPs will need to tell patients not to bother them with trivial issues. Clearly, this remains a short-sighted plan that has little chance of success of implementation.

However, there seems to be little idea on how to plug the £30 billion funding shortfall in the NHS with few politicians having the appetite to discuss future payment options for healthcare. Clearly, there is a significant budgetary deficit and, as a country, we cannot go on borrowing more than we bring in. The public appetite for tax rises to pay for this gap in funding seems to be non-existent. This is clearly the elephant in the room that no-one seems to want to tackle but it seems to be getting so big now that it cannot continue to be ignored. Arranging another reorganisation and using words such as “efficiency savings” is just not going to make this ever-enlarging elephant go away.

Even the lay media has started to pick up on STPs and what they mean. A BBC report found that 28 plans affect hospital care, from full closures to centralising services, such as A&E and stroke care, on fewer sites. The influential King’s Fund has analysed the plans and has warned that a lack of investment will mean the ideas put forward lacked credibility. In their February 2017 update, they state “Over-promising and under-delivering would not be helpful at a time of heightened media and political interest in the NHS”.

What is required now is the political will to be really honest with patients and the public, to confront the elephant and invest in the world-class NHS service that Jeremy Hunt states that he aspires to.

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Luke Koupparis

Luke is a general practitioner in the Bristol area with interests in men's health, child health, minor surgery, online education and medical information technology. He is the IT lead for Bristol clinical commissioning group, LMC representative and chair of the locality provider group. He also works as the medical editor to OnMedica helping to deliver high quality, peer reviewed information to the wider medical community. In his spare time he is a keen road cyclist and likes to ski with his children.
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