A report on the ongoing sustainability and transformation plans suggests that the government needs to make changes to its overarching policy in order to achieve the best possible results.
The King’s Fund suggests that sustainability and transformation presents “an opportunity to move care closer to home and moderate demand for hospital services”.
But the think tank also asserts that the government has failed to invest sufficiently in out-of-hospital care, while cuts to social care and public health provisions are also damaging to the overall healthcare system.
However, the King’s Fund suggests that any plans to cut hospital rights cannot be considered credible “unless investment is first made in services in the community”
The think tank also believes that the ongoing NHS crisis could “divert attention from work to transform care”.
King’s Fund chief executive Professor Chris Ham suggests that the government needs to demonstrate a more coherent policy to sustainability and transformation if the initiative is to be successful.
“It is not credible for the government to argue that it has backed the NHS’s own plan unless it is prepared to support changes to services outlined in STPs. Local plans must be considered on their merits, but where a convincing case for change has been made, ministers and local politicians should back NHS leaders in implementing essential and often long-overdue changes to services. A huge effort is needed make up lost ground by engaging with staff, patients and the public to explain the case for change and the benefits that will be delivered.”
And BMA chair Dr Mark Porter largely concurred with the position of the King’s Fund, suggesting that the funding for the sustainability and transformation programme has yet to be satisfactorily forthcoming.
“The STP process could have offered a chance to deal with some of the growing problems the NHS is facing, such as unnecessary competition, expensive fragmentation, and buildings and equipment often unfit for purpose. We already know that the vital funding needed to carry out these plans simply isn’t available. From the beginning, this process was rushed and carried out largely behind closed doors, by health and social care leaders trying to develop impossible plans for the future while struggling to keep the NHS from the brink of collapse.”
Porter in fact quite strongly asserted that the existing STP provisions are insufficient, and called on the government to ensure that they result in improved patient care, rather than diminished services.
“These plans are fast becoming completely unworkable and rather than transforming the health and social care system, have instead revealed a health service at breaking point – one that is unsustainable without urgent further investment, and with little capacity to ‘transform’ in any meaningful way other than by reducing the provision of services on a drastic scale. Improving patient care must be the number one priority for these plans.”
The BMA chief finally made a chilling assertion that the sustainability and transformation plans could simply be utilised to make swingeing cuts.
“Given the scale of the savings required in each area, there is a real risk that these transformation plans will be used as a cover for delivering cuts, starving services of resource and patients of vital care.”
Responding to the assertions of the British Medical Association and King’s Fund, a spokeswoman on the behalf of the Department of Gealth pointed to the financial progress that has been made in a challenging climate.
“The NHS has worked hard to manage its finances in a challenging period, and the hospital sector’s financial position has now improved by £1.3bn compared to this time last year, with 44 fewer trusts in deficit. While a significant majority of hospitals are now reducing the cost of expensive agency staff, there is more to do to drive efficiencies.”
It was also noted by the spokeswoman that the government has committed to investing in £10 billion in frontline NHS services, although this figure has been questioned by several sources, not least the House of Commons Health Select Committee.