On Saturday 17 September 2016 I attended this STP conference in Birmingham organised by Health Campaigns Together. Attendees were activists from all over England who have serious reservations about the clandestinely created Sustainability and Transformation Plans (STPs). STPs are all about cutting costs, closing acute hospital services and beds, and changing the ways healthcare and social care are delivered.
The Shadow Health Minister Dianne Abbott MP was the keynote speaker. It was important that she attended. She spoke very cogently about STPs and showed much greater commitment to rescuing the NHS than her predecessor Heidi Alexander MP.
John Lister, Director of London Health Emergency, opened the conference with his usual vigour. He said that STPs were all about massive cost cutting all dressed up in ‘happy talk’. There are serious mismatches between what is talked about in the STPs and what is happening on the ground right now. There is no capital budget for STPs. Maybe off-balance-sheet PFI2 debt will be the source of STP capital. As for the private sector, there have been some recent high profile private healthcare company project failures, along with care homes struggling financially and some recent closures.
He made reference to the NW London STP – one of the first to enter the public domain. He cited the lack of detail on how the cuts and reconfigurations were to be achieved. No evidence is provided to convince anyone that the plan is achievable. He also pointed out that we still await the appearance of the final business case document justifying NW London’s STP precursor – the infamous 2012 ‘Shaping a Healthier Future’ (SaHF) strategy. The much delayed SaHF business case was up until recently promised by 18 September 2016, but recent jungle drums tell us it’s now due in January 2017.
STP case studies followed for Manchester (DevoManc flavoured STP), West Midlands and Shropshire. Of the 44 STPs which have been created only six have become public. They from NW London, Hampshire and the Isle of White, Dorset, the Black Country, Shropshire and Devon. Shropshire is perhaps the most successful STP campaigning group. They managed to delay planned A&E closures and really seem to have connected with their local GP LMC. At one CCG meeting 100 of their supporters attended. They have also published a 38 page response to the Shropshire STP.
There were useful workshops on STP analysis, campaigning experiences, building alliances and involving political parties. It’s perhaps no surprise that many areas of England over the last 3/4 years have suffered STP-like ‘dress rehearsals’ very akin to NW London’s SaHF.
The questions and answers sessions along with informal chats with attendees confirmed some facts and revealed some ‘gaps’. It’s clear that there is little awareness of the nature and possible impact of Accountable Care Partnerships (ACPs). However one attendee from Liverpool felt that ACPs will be the enabling vehicle for selling off parts of the NHS. There was no clarity in trying to find out who would receive the capital receipts from selling off NHS land and how that money could be spent. There was a distinct healthcare flavour to this event and perhaps an unfortunate lack of content on social care. Apparently in 2013 we had 140 A&E hospitals in England. When the STPs are complete we will only have between 40 and 70 of them left. At the end of the event we all discussed and voted on a Joint Statement. This is now available on the HCT web site.