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.



Fact sheet for NHS Campaigners

Fact sheet for NHS campaigners

I have been asked to put together a fact sheet which outlines why we have a crisis in the NHS today.  This is what a few people have said to me they would like so they can feel they are able to get out there on the streets to campaign.  I couldn’t agree more that it is essential to know what you are talking about when you campaign on any issue.  But from my own experience of NHS campaigning I have become aware that so many people are confused by why we now have a crisis in the NHS.

The task of putting together a fact sheet is one I have not found easy.  So much has happened since 2010 to damage our NHS and more is still being planned.  It could be a full time job to just try and keep up with the changes.  Keeping up being made much harder by our Government’s attempts to conceal what they are doing and lie to us.  It feels like much of our media is aiding and abetting with these attempts.

But all that said, there are numerous books, websites, the Health Campaigns Together newspaper, local campaign groups and YouTube videoes available for those who want to really know as much as possible.

I am sure I am not alone in thinking that there is something morally offensive about anyone reaping profits from another’s illness.  The right to healthcare is enshrined in the Universal Declaration of Human Rights.  We need to fight for that right because our lives do depend on it.

It is the NHS’s 70th birthday on the 5th July there is a big protest/ celebration of the NHS in London on Saturday.  Make sure you get to it if you can and hopefully the NHS will live to see more birthdays.

Fact sheet for NHS Campaigners

Sustainability and Transformation Plans

The NHS services that East Sussex is going to see reduced

If you ever doubted that our NHS was being destroyed we can now see clear evidence of this as our CCGs start to debate and vote on increasing thresholds for NHS treatments.  We have also seen examples of proposals to ration services by cutting the numbers eligible for NHS treatment by excluding people who for example are obese or smokers.  I have already mentioned in this blog about how individuals from outside the EU are expected to pay upfront for NHS care if they become sick.  That is another example of healthcare rationing. East Sussex Healthcare Trust already has an annual deficit of around £49m.  Our Government has charged STP boards with making changes to absorb deficits.  Cuts are inevitable and it is hard to believe that the changes I am going to mention in this post will achieve the elimination of that deficit.  This is just the start of things to come …

Continue reading “The NHS services that East Sussex is going to see reduced”

Government destruction of our NHS

A NHS that is free at the point of need may soon be a thing of the past

Never before has our NHS been so close to its end as it is now.  We have seen services steadily rationed by NHS bosses dictating a higher threshold for who can be treated or reducing those who are eligible for treatment.  We have seen the introduction of a new policy where overseas residents from outside the EU are expected to pay up front for NHS treatement. Continue reading “A NHS that is free at the point of need may soon be a thing of the past”

East Sussex Healthcare Trust

East Sussex Healthcare Trust and how it is changing

East Sussex Healthcare Trust (ESHT)  provides hospital and some community care to 525,000 people across East Sussex.  It is right for us to know what is happening to the organisations that are there to protect us and our families at times of illness or injury. There are many figures given on their website which chart the changes within the trust although it is a complex discussion.  The services our trust provides have changed over the years,  our population’s needs have changed, the size of our population has changed and investment has been made in terms of new wards and new equipment. But the stark reality is that in 2011/12 ESHT returned a surplus of £87,000 and by 2015/16 they ended the year with a deficit of £48m. Continue reading “East Sussex Healthcare Trust and how it is changing”


Following on from a successful launch event

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The launch of East Sussex Save the NHS Campaign felt like a success.  We had some excellent speeches from Lloyd Russell-Moyle MP;  Dr Carl Walker;  Madeleine Dickens and Dr Mona Kamal.  The enthusiasm of those who attended was evident by the debate that followed in the Q&A session.  Videos from the event were live-streamed to the Facebook group (East Sussex Save the NHS Campaign Forum).   There is so much this campaign can do to fight the destruction of our NHS and protect local services.  But as there is so much to do, we need to get as many people as possible involved.  I am adding a poll to this post to try and get an idea of how many people would be keen to start campaigning and what they feel they could offer.  Please share this post on social networks and with as many of your contacts as possible. Continue reading “Following on from a successful launch event”


Bringing the people of East Sussex together to fight for NHS services

A few facts from the Health Campaigns Together publication in January 2018 reveal a shocking state of affairs in our NHS. 

16,900 people were left waiting in ambulances outside A&E units between Christmas Day and New Year’s Eve – 15% increase in A&E attendances since 2010 – 350% increase in waits in A&E – 550% increase in waits for admission – 170,100 total days delayed transfer of care in English hospitals,equivalent to 5,487 hospital beds – bed occupancy rates remain dangerously high averaging 93.5% – During Christmas week 5,000 people waited more than one hour for paramedics to hand them over to A&E staff – since 2010 we have seen 14,000 beds lost from hospitals, reductions in district nursing and walk-in centres closed – mental health inpatient beds cut by 20% – child and adolescent mental health services at crisis point – an additional 10,000 extra deaths were recorded over what we would normally expect in our hospitals in the first few weeks of 2018 – the UK spends less per capita on healthcare than Ireland, Finland, Iceland, New Zealnad, France, Canada, Germany, Netherlands, Australia, Denmark, Sweden, Luxembourg, USA, Norway and Switzerland.

I  do not believe this is acceptable in the sixth richest nation in the world.  If you agree with me please come to the launch meeting of this campaign on the 9th April.

Continue reading “Bringing the people of East Sussex together to fight for NHS services”


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?”