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STPs will be hamstrung by lack of funding, warn unions

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Lack of funding for controversial sustainability and transformation plans (STPs) could ultimately prove to be their downfall, nurse leaders have warned.

The warning comes after a new analysis found at least £9.5bn in capital funding for buildings and facilities would be needed to support the plans, which have been drawn up across England.

“These plans are fast becoming completely unworkable”

Mark Porter

The analysis by doctors’ union the British Medical Association has fuelled fears that NHS leaders simply do not have enough cash to make the plans work.

Figures obtained via Freedom of Information requests to STP areas have revealed the large sums needed to create the infrastructure to deliver their plans.

Responses from 37 out of the 44 STP areas shows projected capital costs totalling £9.53bn.

More than half have told NHS England they will need more than £100m up front to make changes, with several quoting capital funding needs of more than £500m.

“It is imperative that nurses and other health and care staff are made central to the consultation processes”

Tom Sandford

The BMA said it was unlikely NHS leaders would have “anything like the capital” required to deliver the projects.

The union pointed to the fact that, based on NHS Digital figures, the health service was already facing a bill of more than £2bn to pay for essential repairs to hospitals.

Meanwhile, there was evidence capital funding was being diverted to cover hospital debts and other demands.

BMA chair Dr Mark Porter said there was “clearly nowhere near the funding required” to deliver STPs, seen by many as a mechanism for making swingeing cuts to services.

“These plans are fast becoming completely unworkable and have instead revealed a health service that is unsustainable without urgent further investment, and with little capacity to ‘transform’ in any meaningful way, other than by reducing the provision of services on a drastic scale,” he said.

Mark Porter

Mark Porter

Mark Porter

Following the analysis, the Royal College of Nursing also expressed serious concerns about lack of funding for STPs.

“While the aspirations of STPS may be admirable, the lack of any financial commitment from the government is their Achilles’ heel,” said Tom Sandford, RCN director of England.

“We have always supported the aims of the plans – preventing ill health, joining up services, delivering care closer to home,” he said. “But proper funding – and consultation – is key to making sure STPs solve instead of exacerbate the problems of England’s health and care system.”

Mr Sandford said the college was concerned that STPS would be used to make savings including cuts to hospital beds and community services.

Tom Sandford

Tom Sandford

Tom Sandford

“In lieu of any government commitment to properly fund the health and care system in England, it is imperative that nurses and other health and care staff are made central to the consultation processes, and their knowledge of what their communities need is put at the heart of the work,” he said.

He added: “We hope this will be the final warning the government needs to act on what is now a health and care funding crisis, and the March budget reflects this new reality.”

As part of the NHS England’s Five Year Forward View, clinical commissioning groups, trusts and local government were asked in early 2016 to jointly draw up future service plans across 44 geographical areas. The resulting 44 STPs have now all been published.

However, while the original aims were described as looking at ways of providing more care in community settings and introducing more efficient care models, STPs have increasingly attracted controversy.

As reported by Nursing Times, there has been concern about attempts to cut back on nursing workforce resources in some of the plans, while local MPs and campaigners have raised fears of hospital service closures.

In one recent development, organisations in an STP area have been seeking help to promote their plans to the public as a positive step and tackle widespread perceptions that they represent cuts.

As revealed by Health Service Journal, Humber, Coast and Vale STP recently invited marketing agencies to express an interest in a “social media and guerrilla marketing campaign” for its proposals.

One of the key goals of the campaign would be to “turn down the noise about cuts to services and risks to the NHS”.

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