NHS transformation plans face uncertain future following election
The election result has left the future of NHS Sustainability and Transformation plans 'weakened and in jeopardy', says Dods Monitoring's Rosie Lythgoe-Cheetham.
Although an iconic national institution, the NHS in 2017 faces an uncertain future. Limited resources, chronic management inefficiencies and the realities of Brexit’s impact on staffing levels mean that drastic change is inevitable. The Government’s Sustainability and Transformation plans (STPs), which will combine local authorities and NHS services for more efficient care, aim to change this.
As part of the NHS Five Years Forward View, published in March 2017 before the General Election, every local healthcare system in the UK must put forward a proposal for their own STP. These must combine health services with local authorities and social care in the area. It is hoped that integrated systems will better match our changing societal needs and reduce inefficiencies.
NHS England’s Director of Primary Care Dr Arvind Madan believes that although the implementation of STPs is a lengthy process, it will eventually lead to more synchronised healthcare for patients, which provides better value for the taxpayer; “The NHS has always responded and adapted… we have to strive for a better system that not only responds to pressures but can also innovate and reduce them”.
With an ageing population, a care system which moves closer to home is both cost efficient and more safe and convenient for patients. Minor surgery will move to local practices and pharmacy provision will increase, meaning that hospitalisation is widely reduced and older patients need not fear delayed discharge or excessive time away from home. In turn, this slimmed down system will reduce pressure on A&E services and free up much needed funds for use elsewhere in the NHS.
This July, Health Secretary Jeremy Hunt announced £325 million investment for local healthcare improvement, which will begin the STP process. Hunt said, “this funding will support strong local plans to help the NHS modernise and transform care for patients… there are already excellent examples of this across the country and this money will allow them to go further and faster.” This gradual STP process reduces the patient safety risk of huge, rapid change in the NHS and halting mass hospital closures in the near future has made Mr Hunt popular.
The Labour Party are highly sceptical of STPs and see them reducing the quality of care for local patients, in a cold, austerity driven move. Hospital and clinic closures are inevitable and would cause major disruption for regular patients who would have to travel longer distances for treatment. Shadow Health Secretary Jonathan Ashworth would implement a grassroots analysis of each STP, claiming that decisions are being made “behind closed doors with no genuine involvement of local people”. The British Medical Association claim that STPs are “sneaky”, leaving the NHS chronically underfunded in the transitional period and with no provision for accountability. Indeed a staggering two thirds of the 44 existing STPs include hospital closure or relocation. The NHS Confederation, although not wholly in opposition to STPs, suggests that an extra £2 billion per year would still be needed for the NHS to cope with such massive change, as our health service is already “struggling to cope with demand”.
Following the Conservatives’ failure to form a majority Government in June 2017, STPs have been put on ice, with ministers citing a ‘lack of consensus’ and a focus on Brexit for the delay. Jeremy Hunt has said that “the legislative landscape has changed… it’s realistically not something we would do [STPs] while the Brexit process was carrying on.” Hunt’s difficult position leaves the STP process confused, in jeopardy and looking weakened.
It’s clear that sustainability transformation plans in some form are necessary for NHS survival but in these uncertain times, the complete overhaul of our health service which Jeremy Hunt has planned now seems near impossible. As it stands today, accident and emergency departments are in chronically overstretched, doctors surgeries full to capacity and older patients facing delayed transfers of care. Whilst STPs will certainly help to alleviate these issues in the long term, our health service will only change with a variety of different solutions to an long list of huge challenges.
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