Intended for healthcare professionals


STP plans to cut GP numbers are “alarming,” says royal college

BMJ 2017; 356 doi: (Published 02 February 2017) Cite this as: BMJ 2017;356:j598

Re: STP plans to cut GP numbers are “alarming,” says royal college

The NHS has required forty four identified planning footprints across England to produce a Sustainability and Transformation Plan (STP). The 44 footprint leads were given the task of breaking new ground in the battle to close the three fundamental gaps in health: health and wellbeing, care and quality, and finance and capacity 1, with the underlying message that money has to be saved. This was also opportunity to radically transform the NHS, to re-think where the majority of money is spent and identify where action may see the biggest bang for our limited buck.
The cost of men to the NHS is great; they have higher rates of hospitalisation across nearly all diseases, have higher accident rates and greater rates of premature death and disability. They are less likely to take up screening and yet more likely to develop cardiovascular disease in their early years and develop and die from nearly all cancers. This is driven by higher rates of smoking, alcohol intake, hazardous working, mismanaged emotional and mental health problems combined with the issue that men are more likely to be overweight with harmful abdominal fat amongst other socio-cultural and biological factors2,3.
Looking at the published STPs, 15 of the 44 note that men have higher rates of death – 29 do not. Eleven comment specifically on the more negative impact of austerity on men – including the 20 year life expectancy difference in the Humber, Coast and Vale STP4. But that’s it – there is no mention of what is to be done, no focused targeting of this biggest financial burden (as well as the health and wellbeing, care and quality gaps in provision!). That there is not a single inclusion of the word ‘men’ or ‘male’ in 22 of the STPs compounds the feeling that men have been invisible in the health service and may remain so – despite them being a protected group under the Equality Act.
As these are drafts there is still time for a re-think especially as there is now talk of a new national NHS Five Year Forward View delivery plan; there needs to be a wake-up to the benefit of reaching out and targeting men on the overall health and wellbeing of the nation – as well as reducing the cost.
1. NHS. Five year forward view [Internet]. London: NHS England; 2014. Available from:
2. White A, Seims A, Newton R. The State of Men’s Health in Leeds: Main Report. Leeds: Leeds Beckett University, Leeds City Council; 2016.
3. Seims A, White A. The State of Men’s Health in Leeds: Data. Leeds: Leeds Beckett University, Leeds City Council; 2016.
4. NHS. Humber, Coast and Vale STP. Humber, Coast and Vale: NHS;

Competing interests: No competing interests

14 March 2017
Ian Cameron
Director of Public Health
Alan White, Centre for Men’s Health, Leeds Beckett University, Amanda Seims, Centre for Men’s Health, Leeds Beckett University, Tim Taylor, Public Health Commissioning Manager, Leeds City Council
Leeds Civic Hall, Calverley Street, Leeds LS1 1UR