There was a bit of noise during the election campaign around the government’s latest move in the continual and discreet reorganisation of the NHS – the STPs aka Sustainability and Transformation Plans. This noise of protest centred on rumours of cuts some STPs are going to make.
This kind of noise will get very loud indeed as the plans of some of England’s 44 STPs focus on money saving closures of services and buildings – all in the name of sustainability with reduced funding. But in case we got frightened by ‘plans’, the STPs have had their ‘P’ changed to the cosier and much more user friendly ‘Partnership’.
‘Plans’ end when they are implemented – ‘partnerships’ can go on for ever. STPs are here to stay. The last reorganisation of the NHS went unsteadily through Parliament and became the Health and Social Care Act 2012.
This reorganisation is being carried by stealth – whatever happened to the sovereignty of Parliament? It is adding a whole new layer to NHS organisation and bureaucratic costs. It is all but returning to the pre-Lansley days of Strategic Health Authorities.
Along the way someone seems to have missed the opportunity to get away from an acronym that still sounds to many like a particularly unpleasant sexually transmitted disease.
The STP for Wiltshire includes Swindon and Bath & North-East Somerset. It has been led by James Scott – the Chief Executive of the Royal United Hospitals (RUH) in Bath – he oversaw the plan that had to be drawn up for government.
He has now stepped down. We are told this is partly because the board of the RUH need him back full time to sort out their financial issues. But also partly because NHS England ruled the STP needed a full time leader and Mr Scott did not want to go through the selection process – or even, perhaps, want the job.
Watch out for the advertisement for our STP’s full time leader/director/boss. We shall see what title he or she is given.
The main point about our STP is that it has no plans to close hospitals. As the head of Healthwatch Wiltshire said this week: “It’s very much business as usual.”
That is the positive side. The more negative side is that our STP has – so far – included no capital projects. So, for instance, it includes no capital request to enlarge Great Western Hospital to fit Swindon’s fast growing population.
But then, we are told, the STP is not a one off plan, but has now become a rolling responsibility for health services in the ‘footprint’ of the Partnership.
And how will the Partnership work in Wiltshire when Wiltshire Council gains more leverage (as we have seen this week) over the county’s health services and will want to put ‘Wiltshire first’? After all, Wiltshire councillors were not elected by the people of Swindon or Bath.
But the invention by Lansley of the Clinical Commissioning Group was to “…empower NHS professionals to improve health services for the benefits of patients and communities. It will remove political interference and micromanagement in decisions about people’s care.”
Now, it seems, elected politicians are to be given back power over NHS budgets at a local level. How are we expected to square that circle?