Sustainability and Transformation Plans

Sustainability and transformation plans

What are these plans and why are so many people angered by them?

As nearly all NHS Trusts now have rising deficits something had to change.  Simon Stevens, Chair of NHS England, has come up with a five year forward view which aims to ensure the NHS is sustainable.  STPs are the government imposed implementation of this five year forward view.  It is claimed that the major aim of STPs are to integrate health and social care, creating collaboration rather than competition to streamline health and social care pathways.  All sounds good, so why the opposition?

Journalist, John Lister, has written this extremely powerful document examining the inadequacies of STPs – The-Sustainability-and-Transformation-Plans-a-critical-assessment-FINAL-WEB  it is something that is well worth a read.

In a similar vein, Prof Chris Newdick writes about the Problems of Legal Status and Accountability with STP teams – the envisaged interagency groupings who will implement the meat of the STPs.  Newdick explains the pitfalls of the fudges that come with promising to ‘do more with less’ -just when we need to be clearer than ever about rights and duties in the NHS.  He concludes that: “We need a new National Health Service Act to stabilise the NHS’

These reports resonate with concerns from others across the health world.  Have a look at them and then Tweet, Facebook or email your friends and colleagues about them now to help spread the word.

England has been divided up into 44 regions, or footprints as they call them.  Every region has their own STP board, which is a body of unelected people who are tasked with drawing up the STP for their footprint.  STPs are designed to implement massive savings, absorbing all the deficits of NHS trusts by 2021.  This would represent a £30bn cut in spending on our healthcare services, a 25% reduction from the £119bn spent in 2015-16.

These plans aim to devolve responsibility to local authorities, shifting the blame for NHS failures from Westminster to local authorities and CCGs.   Sussex and East Surrey are in footprint 33 which will need to cut a staggering £864 million by 2020/21.

Although blame will be planted on local authorities when failures in local NHS services occur due to these savage cuts the STP boards have been granted the power to over-ride the local authorities.  So we have officials who have not been elected with greater power than those who we do elect.  Hardly democratic is it?

Every region will have an Accountable Care Organisation (ACO) to run and carry out the development of STP.  Some local authorities are setting up Special Purpose Vehicles (SPV) to enable them to run ACOs.  ACOs will become prime targets for corporate takeover.

There has not been any sign of public consultation over these plans.  Sussex Defend the NHS and many of its supporters have written to the Chair of our local STP board expressing their concerns but received only a very bland reply in which he stated that: “I give you my personal assurance that no decisions have been made and will not be made without giving our patients and the public the opportunity to comment and engage.”

Despite the claims that STPs will involve public engagement it seems that in footprint 33 these plans have already been incorporated into all the CCG operating plans excluding those in West Sussex.  There is still no sign of any public engagement.

Money has been spent by employing private consultancy firms to give their input into these plans, it is likely we will see:

  • Reductions in the number of sites where healthcare is provided – so patients and visitors will have to travel further, take more time off work, arrange more childcare etc
  • Patients discharged quickly – As soon as patients no longer need medical intervention they will be discharged – post-operative monitoring and care will become the responsibility of family members of chargeable social care.
  • Reductions in NHS staff – And more pressure placed on remaining staff
  • Downgrading of professional roles – Replacing fully qualified doctors  with ‘physician assistants’ who will have just two years training, or replacing qualified nurses with health-care assistants.
  • Reliance on digital monitoring – Computerised questioning leading to diagnosis and treatment along with Skype interviews – may be good for some patients but hugely problematic for others.
  • Keep up to date with the Stop the Sustainability and Transformation Plans website

STPs stress the importance of self-care and prevention rather than treatment but there has been little or no planned investment to support this.  There may be greater integration with social care but local authorities have already cut 33% from the social care budget which is now suffering from chronic underfunding.

So are these plans something that the UK has no choice but to implement?  Is it perhaps unreasonable to demand that there be no swingeing cuts to our NHS?  After all we have a national debt of over £1,800,000 m and its rising fast! (Follow this link to see just how fast)

The UK is the 6th largest economy in the world yet we spend far less per head of the population or % GDP than comparable countries such as France or Germany.  We can afford a decent and modern NHS – after all, we set it up at a time when Britain was heavily in debt after the war.  The system of a state provider of healthcare funded through taxation in known to be the most efficient means of delivering healthcare for any nation.  It would make sense to stay with the most efficient system we can find. We also need a healthy country to grow our economy and run our businesses.

Opposition to STPs is growing with over 30 local authorities already having rejected the plans for their areas.  Although STP boards have the power to over-ride  the concerns of local councils it is hugely symbolic if we can get more councils rejecting the plans.

If these plans go through it could lead to a total destruction of our NHS.  These plans have been nick-named Slash, Trash and Privatise.  Just as Maggie did with our railways when she put British Rail through years of underfunding.  The NHS is now going through a similar phase.  As fault lines appear, the media will exaggerate them, public dissatisfaction will grow and then our government will present privatisation as a solution to the problems we have in our healthcare.

So make no mistake, our NHS is not failing, it is still doing a fantastic job, but it is being failed.

What can we do to halt this destruction? 

  • First and foremost don’t succumb to trashing the service
  • Remember we can afford the NHS –  we can’t afford to not have our NHS
  • Share and follow this website, talk to your friends and family about it
  • Write a letter to your MP and councillors, here are some template letters you can download-  Letter to Councillors etc
  • Start cross examining anyone who comes to your door canvassing for the elections we have coming up – find out their views on the NHS and make your concerns known
  • Show the NHS staff who are over-worked and suffering from years of pay restraint just how much you appreciate them
  • Sign this petition to defend our NHS
  • Remember that the NHS belongs to US

This campaign will work closely with Sussex Defend the NHS who have set up a Footprint 33 Regional Network of Opposition to STP.




Launch meeting for the East Sussex Save the NHS Campaign

A speaker event has been arranged for the 9th April  to launch this campaign group.  Speakers will include: Dr Carl Walker; Madeleine Dickens from Sussex Defend the NHS and Lloyd Russelll-Moyle MP for Peacehaven and Kemptown.  The event will be held in the Central Hall of the View Hotel on Grand Parade in Eastbourne from 7.00pm to 9.00pm.  Doors will open at 6.30pm.  If you are interested in attending this meeting please register through our Eventbrite page.  We will allow time at the end of the meeting for a Q&A session. There is disabled access.   Please share with your contacts news of this meeting.


Say the wrong things and we may lose the NHS completely

Many of us will have heard the term Slash, Trash and Privatise.  It is the preferred approach of many governments wishing to gain public support for the privatisation of a vital service.  And this government is proving to be no different,  They are slashing the funding of our NHS then watching the service deteriorate and the public satisfaction grow.   Could all the recent talk about the current pressure on A&E units do nothing more than signal to our government that now would be a great time to tell us the NHS is being sold off?  The words we use when we discuss the NHS may be the deciding factor. Continue reading “Say the wrong things and we may lose the NHS completely”

The media and our NHS

Why our media is failing to protect the NHS

Our media is there to inform us.  It is a crucial body in the running of any democracy.  By providing citizens with factual information as to what the authorities are doing they empower us all.  Without that factual information we stand no chance of being able to challenge decisions of authorities that may damage our lives.  Democracy is about us having a say in how our country is run, but as far as the NHS is concerned our media seems to be removing any chance of democratic decisions being made.  This won’t just damage our lives it can, and is, ending lives. Continue reading “Why our media is failing to protect the NHS”

Accountable Care Systems

Accountable Care Systems – why import something so bad?

Graph comparing different nations healthcare costs and efficiency

Sustainability and Trasformation Plans (STP) are being drawn up in secret by bodies that lack any legal status with no public consultation and from that process we are now seeing the emergence of Accountable Care Systems and Organisations (ACS/O).  These too lack any public engagement, transparency or legal status.

So far US-style Accountable Care Systems are planned in just eight regions but we have good reason to fear that the intention is to roll out this system across the whole of England eventually.

We have good reason to fear the impact that ACS will have on the healthcare system that is available to us.  This post will aim to explain why.

Continue reading “Accountable Care Systems – why import something so bad?”

Sustainability and Transformation Plans

Update on threats to our hospitals

Our hospitals are the next in line for severe cuts in funding from this Tory government hell-bent on destroying our healthcare service. Sustainability and transformation plans (STP) for primary care have already been incorporated into the operating plans of our CCGs.  But we are now waiting for the publication of plans for our hospitals.  These plans are being drawn up in secret with no public engagement.  There seems to be a media blackout being applied so most people are left unaware of just how far the intention to finally put the nail in the coffin of our NHS goes.  Here is an update of what we know is going on in this footprint (region).

Continue reading “Update on threats to our hospitals”

Naylor Report

NHS up for a quick sale! The Naylor Report

NHS- not for sale sign

You may like me be starting to struggle to keep up with rotten government policies that seriously threaten our quality of life.  They are after all bombarding us with news of proposals for changes to how our country is run and it would be impossible to fight every proposal even if we wanted to.  But the NHS is something that matters to most of us, it is there to keep the country healthy.  The Naylor Report is something that we all should know about.  And, we need to understand why it is such a worrying proposal. Continue reading “NHS up for a quick sale! The Naylor Report”

NHS birthday card campaign

NHS birthday campaign

NNHS birthday card campaign

The NHS was created on the 5th July 1948, an appropriate time to set off with this campaign’s first street action.  We were out in the town centre of Eastbourne on three days in the run up to the 5th July.  The campaign had a simple message –  The NHS is not failing it is being failed, the only reason it is not failing is due to the hard work and dedication of NHS staff.  We asked the public to sign a birthday card for the NHS and say thank you to it staff. All the birthday cards were delivered to the DGH on the NHS birthday. Continue reading “NHS birthday campaign”


Psychaitry – the Cinderella service of the NHS

Silhouette of woman sitting in a dim room

I speak from bitter experience of mental illness.  I have experienced the best and worst of psychiatry.  The best came just a few years ago when I finally was diagnosed correctly and the doctors admitted they didn’t know how to help me. It was a groundbreaking moment to be told by one psychiatrist that he had no idea how to help me because nobody had ever admitted that before, although I had known it was true.  My story reflects how little understanding there is of mental illness.  I was successfully treated eventually but the unit I was treated in closed four years later.  My story also reflects how psychiatry is now going backwards. Continue reading “Psychaitry – the Cinderella service of the NHS”

General Practice

A changing climate for GPs

GP surgery

Many of us will have heard GPs talking about their almost unmanageable workload.  Even more of us will have noticed just how hard it can be to get a GP appointment when we need one.  The importance of primary care should not be underestimated, it is primary care that keeps us from needing hospital admissions.  It may also keep vulnerable patients safe and out of crisis.  To start damaging primary care is very unwise as it may simply translate into patient harm, increased pressure on hospitals and increased costs for the state. So what is happening now with primary care? Continue reading “A changing climate for GPs”