Underfunding Problems Emerge in Cheshire and Mersey

A leaked document has indicated that a major transformation plan in the north west is significantly underfunded.

Over £750 million of investment is required to drive a sustainability and transformation plan for Cheshire and Mersey.

This is revealed by the STP submission for the region, led by Louise Shepherd, chief executive of Alder Hey Children’s Foundation Trust.

The document which is to be submitted to NHS England outlined the extent of understanding in the region.

“We recognise that these plans are heavily dependent upon capital – up to £755m additional funding requirement in current plans. However, we recognise there is still significant work to do before these high level requirements are turned into robust business case ready solutions. In particular to fully articulate the cost/benefits associated with the proposed investment. We also understand that capital funding is extremely limited and that we will need to focus investment in those schemes that provide the most beneficial impact on our STP plans.”

NHS England has requested for leaders of trusts to refrain from publishing STPs at this juncture.

The Cheshire and Mersey document also suggests that there is a fundamental lack of contingency funding.

“The size of the current gap is an estimate and more work to agree the future assurance framework is yet to be completed. However, two dimensions can be described in that: firstly, the current level of planning has no level of contingency (indicatively 25-50 per cent) that would normally be associated with programmes of this size and complexity. Secondly, the robustness of the ‘plans’ and associated risks regarding measurability, capability and deliverability all serve to make us discount the current value of the whole by a figure of 30 per cent equating to some £300m.”

And there are clearly issues related to capacity and capability, with the document indicating that questions raised by the organisation have yet to be satisfactorily resolved.

Staffing problems are particularly rife, with the authors of the document noting that delivering a change program of this magnitude without freeing up key members of staff from other departments is simply impossible.

“The lack of transformation capacity and expertise released from within the system will result in momentum being lost. We are at a watershed moment and the membership group has recently agreed to consider all requests for capacity and skills in the light of insufficient progress being made to exploit the goodwill and discretionary efforts of all those contributing to this plan to date,” the document asserts.


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