Julia Simons – until recently head of NHS England’s commissioning policy unit
SOUTH EAST LONDON STP NOW PUBLISHED 4 November 2016
We are currently reading the Sustainability and Transformation Plan and will be issuing a statement shortly.
UPDATE On Wednesday 23 November the full Lewisham Council voted as follows:
- Request full publication of all associated documents and appendices
- Request pre decision scrutiny on changes to NHS and social care provision locally
- Require full public consultation on significant changes to any service
- Call on HM Government to provide the resources to fund good quality services across South East London
- Reaffirm its commitment to an Accident and Emergency Department on the Lewisham Hospital site
See full motion here
To see how our Campaign and Councils are responding to OHSEL’s proposals to put elective care into 2 centres, most probably excluding Lewisham and Greenwich Trust, please click here.
Our critique of the STP plans can be seen by clicking on the link below.
Our concerns are for Lewisham and Greenwich Trust and its patients, which includes both hospital and community services, but also for the whole of the population of SE London.
OUR RECOMMENDATIONS TO LEWISHAM COUNCIL AND ALL SE LONDON COUNCILS
- That individual CCGs and Local Authorities in SE London do not give their approval to the OHSEL STP
2. That the six CCGs and six LAs inform NHS England that good and safe care cannot continue without adequate funding – failure to provide this is seriously undermining health and social care
3. That elected representatives, councillors, the Mayor and MPs, write to the Local Government Association, the Prime Minister and explain why the NHS and social care must be funded properly urgently
4. That the cooperative work to improve health systems in the community continue but in the realistic context explained above.
5. That the proposal to centralise care in two Elective Orthopaedic Centres in SE London is abandoned because:
(a) it is expensive and too risky to the overall health economy;
(b) care can be improved by each of the three main elective surgery providers retaining a centre in each trust, but with additional funding to ensure a streamlined elective surgery service available to the residents of each of the six OHSEL boroughs.
6. That workforce plans should prioritise the training and recruitment of more nurses in community and hospital, more GPs to fill the existing vacancies and to meet the predicted shortfall, and more hospital doctors.
(a) These measures would ensure vacancies are reduced and reliance on agency cover is minimised;
(b) OHSEL, the six CCGS and six LAs need to make clear to national bodies and government that workforce plans need to be overhauled rapidly.
WHAT IS AN STP?
STP stands for Sustainability and Transformation Plan – or ‘Secret Tory Plans’!
NHS England has divided up England into 44 regions or ‘footprints’ (who knows why they thought of this title) – and each area has been asked to develop an STP.
Our area is South East London – and consists of six boroughs – Lewisham, Lambeth, Southwark, Greenwich, Bromley and Bexley.
An organisation called Our Healthier South East London – which has been working on planning on changes to the NHS in the last 3 years – has now become the organisation responsible for the STP.
The STP also involves the six local Councils who respond to the STP and other health issues individually but also through a regular joint meeting called the Joint Health Overview and Scrutiny Committee (for the OHSEL area). Our campaign now attends this and other meetings – Lewisham Overview and Scrutiny Committee, the Healthier Communities Select Committee, Lewisham CCG and OHSEL meetings on various issues, to monitor developments and intervene where possible.
WHAT IS THE PURPOSE OF THE STPs?
Despite the rhetoric, the ‘transformation’ is about saving money (£22b reduction in annual funding by 2020), downgrading, cutting and where necessary using the private and third sector to do things on the cheap.
The SE London STP has only just come into the public domain (4 November 2016) and it is unclear whether or how much the public will be consulted.
The STPs – forced through by the Government and NHS England in record time – are leading to unrealistic savings – often involving double counting, unrealistic plans, in an atmosphere of secrecy. Plans had to be submitted by the end of June and implementation is due to begin early in 2017.
Julia Simon, who until earlier this month was the head of NHS England’s commissioning policy unit, warned: ‘Forcing health and care organisations to come together so quickly to draw up the complex care plans was likely to backfire. Up against tight deadlines, organisations were likely to make unrealistic financial forecast and claims about benefits to patient care.’ She added: ‘Everyone will submit a plan, because they have to. But it means there is a lot of blue sky thinking and then you have a lot of lies in the system about the financial position, benefits that will be delivered – it’s just a construct, not a reality.’
The STPs include local councils and so for example the plans are meant to take into account social care for the elderly. Government cuts to councils mean that there have been massive reductions in money available for social care for the elderly. For example since 2011 government cuts have resulted in a £4.6bn reduction in social care budgets in England which represents a cut of 31% with 40% of cuts coming from frontline services. This means that more than a million older people have an unmet need and receive no help from the local authority, family or friends.
The Health Service Journal has recently pointed out that ‘STPs offer private sector ‘enormous opportunity’ and that Sustainability and Transformation Plan leaders could establish “strategic partnerships” with independent sector organisations, a senior NHS England director has suggested.
Huffington Post article
WHAT HAS OUR CAMPAIGN BEEN DOING ABOUT STPs?
The Save Lewisham Hospital campaign joined together with Lambeth Keep Our NHS Public branch to research what we knew about STPs. Our main concerns have been to:
- Find out what is in the STP for South East London
- Funding – this is a key area because the whole existence of the STPs is about saving money, savings have double counted on occasions, or been based on wrong figures.
- Community care – without any real evidence, NHS England is using the STPs to pushing the misleading story that community based care can hugely reduce numbers admitted to hospital. The savage irony is that, under cover of this rhetoric, cuts are being made in community care for the elderly, the disabled, children – everyone.
- Talking to OHSEL – we have been attending OHSEL meetings, CCG meetings and talking to those who are charged with implementing the STPs and putting forward out views.
- Here is a letter to OHSEL from the Save Lewisham Hospital Campaign and Lambeth Keep our NHS Public. Click here to see letter
- Attending council meetings – we have been writing to our elected councillors and attending council meetings. Click here for letter to Councillors
Excellent article by Colin Leys on STPs