Sixty seconds on . . . STPs
BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5752 (Published 26 October 2016) Cite this as: BMJ 2016;355:i5752
Oh, no, not more NHS jargon. I’ll skip this one
Sustainability and transformation plans (STPs) may sound like a boring agenda item, but they have huge implications for the NHS.
Really? How so?
The plans, unveiled by NHS England last December, have three overarching aims: to improve health and wellbeing, to improve quality of care, and, crucially, to achieve financial balance. Nigel Edwards, chief executive of the health policy think tank the Nuffield Trust, says that the plans have the “potential to make fundamental changes in the shape and nature of health care services.”1 He warns that in some areas up to 20% of beds may be cut and that the number of hospital emergency departments is likely to change (that is, they will close).
So, they’re about saving money?
Basically, yes. Amber Davenport, head of policy at NHS Providers, says that the “triple focus” of the original aims have morphed into “money, money, money” and that they’re now more about balancing the books by 2020-21 than anything else.2 And the chief of the health think tank the King’s Fund, Chris Ham, told the Guardian newspaper that the plans now have little to do with transformation.3
Who is drawing up these plans?
Representatives of local areas across England have come together in 44 STP “footprints” (areas that are collaborating). Some footprints mirror existing partnerships, while others bring together organisations for the first time.
So, why have I never heard of them?
The timetable for the plans is astonishingly tight (at best ambitious and at worst unrealistic, says Davenport). Footprints came together at the beginning of this year and were meant to have submitted plans by the end of June—however, that was postponed to the end of October. Edwards believes that such a tight deadline means that running a large scale public consultation was impossible.
Where can I see these plans?
That’s the million dollar question. A spokesman for NHS England told The BMJ in August that the plans would not be published centrally and that it was up to the footprints themselves to unveil them to the world.4 The campaigning organisation 38 Degrees has tried to find out more detail about the plans but has drawn a blank in many cases and has warned over the lack of scrutiny of the plans.5
Footnotes
thebmj.com Editorial NHS in England embraces collaboration in tackling biggest crisis in its history doi:10.1136/bmj.i1022; Observations The NHS’s sustainability and transformation plans: doing so much with so little doi:10.1136/bmj.i2380; Feature NHS sustainability and transformation plans: proposals for savings lack scrutiny doi:10.1136/bmj.i4449; News Transformation plans are overambitious and will not work, say service leaders doi:10.1136/bmj.i5545
BMJ Blog Clare Marx: Give sustainability and transformation plans a chance http://bmj.co/STPs