Hospital Dr News

BMA reveals “costs” of STPs and calls for re-think on the way forward for NHS

The implementation of Sustainability and Transformation Plans (STPs) – the government’s key way of implementing its Five Year Forward View – is creating a new expensive bureaucracy.

This is the claim of the BMA, which says the plans are simply a cover for making £26bn in cuts to health and social care.

BMA analysis suggests STPs have created a £8.5m salary bill for new health managers and £1.1m spent on private consultancy firms and agency staff.

Furthermore, the union says, millions of patients could be affected by hospital and A&E closures and bed losses.

The BMA says the actual numbers are likely to be much higher, with only around half of the 44 STP footprints responding to their Freedom of Information requests, and others unable to give detail of remuneration for some staff.

The investigation has also revealed a major disparity in the processes being carried out across the country. In some areas, like Lincolnshire, health leaders said they were using the resources already at their disposal to move the STP process forward – but in others, like North East London, up to 37 new staff have been employed, and whole ‘project management teams’ have been created.

These figures come alongside a new report on STPs published today by the BMA, analysing all 44 STP plans. The report finds that:

  • 17.6 million patients could be affected by hospitals closing or merging (including both community and acute care);
  • 22.9 million patients could be affected by A&Es closing or downgrading;
  • 14.7 million patients could be affected by acute bed closures;
  • 6.6 million patients could be affected by community bed closures.

The report also found that:

  • There has been a poor engagement with clinicians, patients and the public considering the scale of patients affected;
  • Rushed timelines and the scale of the financial challenge mean that plans are being implemented without the appropriate evidence;
  • The upfront funding needed for to deliver plans has not been provided;

Previous BMA research has found that the 44 STPs will have to make at least £26 billion in cuts to keep inside the public funding constraints set by the Government and that the plans require at least £9.5 billion of capital funding.

Dr Mark Porter, the outgoing Chair of BMA Council, said: “Millions of patients will be affected by hospital and bed closures under these so-called ‘transformation plans’, which are a cover for delivering £26bn in cuts to health and social care.

“It makes no sense to spend this kind of money on staffing and structure when we already know there is a huge shortfall in capital funding needed to actually put the plans in place. Any money spent here runs the risk of being completely wasted.

“With the NHS at breaking point, doctors and patients will be horrified to see millions being spent on another layer of bureaucracy to deliver these controversial plans. The NHS needs more GPs, junior doctors and consultants – there is nothing sustainable or transformational about creating another costly team of managers while staff on the frontline struggle and patients suffer as a result.”


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