What are NHS Sustainability and Transformation Plans?
Sustainability and Transformation Plans are being created nationwide as a means of planning, organising and implementing the government's aims of overhauling the delivery of healthcare by 2021.
The NHS Five Year Forward View
The anticipated changes to the NHS and associated services and organisations are founded in the government's report in December 2014, The NHS Five Year Forward View.
This document identified the increasing difficulties in delivering adequate and effective healthcare nationwide, emphasising the following factors:
- A growing population with people living longer
- More complex health issues in many patients
- Unhelpful lifestyle choices such as smoking and alcohol abuse
- Increasing rates of obesity
- Financial pressures in a time of budget restraints which are likely to lead to a significant funding gap by 2020
The NHS is also facing nationwide staffing shortages which compound the difficulties of increasing demand to create crises such as currently being experienced in A&E services.
Looking for solutions, the Five Year Forward View proposes fundamental changes in approach including:
- Greater focus on local leadership, collaboration between services and localised decision-making
- Emphasis on encouraging healthy living with a view to the population remaining healthy and reducing demand on health services
- A greater focus on out-of-hospital care
Sustainability and Transformation Plans
Sustainability and transformation plans, identifying new structures and ways of working across 44 geographical areas in England have been created under collaborative teams within each region to clarify how the NHS will achieve the following goals:
- Improving quality and developing new methods of care
- Improving health and well-being
- Improving efficiency of services
A key aim is to adopt an integrated, multi-service approach to the delivery of healthcare through more collaboration and networking between hospitals, GPs, social care providers etc.
Another fundamental aim is to encourage and support healthier lifestyles amongst the general public with a view to reducing the demand on the NHS.
Further aims include: improving mental health services; ensuring greater consistency of provision across the health care system; and improving staff recruitment across the NHS in order to try to reduce pressures and improve the quality of the service.
Responses to the STPs
The King's Fund, an independent thinktank on health has described the STPs as 'an important opportunity for improving health and care services in England.'
Concerns have been expressed, however, that the STPs are driven by a desire on the part of government to curb spending and reduce the NHS deficit rather than a desire to improve the quality of the service provided by the NHS and healthcare providers.
Criticisms have also focused on lack of collaboration in the planning stage and fears as to the possible closure of hospitals, A&E units and reduction of bed capacity at a time when demands on NHS beds are consistently exceeding the recommended level of 85%.
British Medical Association
Last year, the British Medical Association expressed concerns about a variety of issues related to the development and implementation of the STPs:
- The amount of money being spent on managers and consultants in order to develop and deliver the new proposals
- The impact on patients of proposed hospital closures and mergers as well as A&E closures
- The lack of involvement of patients and the public in the development of STPs
- The impact of tight deadlines for development of plans
- The lack of funding and the impact of cuts designed to meet financial restraints
Dr Mark Porter, chair of the BMA council commented that "Millions of patients will be affected by hospital and bed closures under these so-called 'transformation plans' which are a cover for delivering £26billion in cuts to health and social care."
Hospital Consultants and Specialists Association
A survey by the HCSA last year, as reported in the Guardian, found that three-quarters of the hospital clinicians approached in the survey believed that STPs were a way to bring about cuts in the NHS.
Furthermore, the vast majority had not been involved in the development of their local Sustainability and transformation plan.
Royal College of Nursing
In a recent article on the Royal College of Nursing website, Sheila Marriott, Regional Director of the RCN in the East Midlands raised a concern about the timing of implementation.
Two associated prongs of the STP approach are the reduction of acute hospital beds and the development of improved community or out-of-hospital care. The regional director's worry was that the former might be carried out before the latter had been developed to the point where there would not be a reduction in patient care. Cross-service co-ordination is vital to maintain the quality of service.
Medical Negligence
The development of sustainability and transformation plans is a recognition of the huge pressures under which the NHS is currently struggling. Demands continue for increased government funding to enable the service to recruit more staff and provide a better service. Insufficient funding will only continue to impact on the safety of patients as emphasised in a letter to the Health and Social Care Secretary this week.
If you or a loved one have suffered due to a significant failing in care, you may be entitled to make a claim for compensation.
Contact Glynns Solicitors, a specialist medical negligence legal practice, to discuss your situation with an experienced solicitor.
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If you or a loved one have suffered from the appalling experience of sepsis due to a failure to recognise or respond to the dangers of sepsis in relation to abdominal surgery, you may be entitled to make a claim for compensation for your suffering.
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