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STPs are creating ‘undeliverable’ plans, says NHS Providers chief


12 October 2016

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The sustainability and transformation process is at risk of “blowing up” because providers are drawing up “vastly over ambitious” plans, the chief executive of NHS Providers has said.

Chris Hopson told the Health Select Committee yesterday that nearly every member of NHS Providers is working on undeliverable plans to meet their 2020/21 financial allocation set by NHS England in May.

The sustainability and transformation process is at risk of “blowing up” because providers are drawing up “vastly over ambitious” plans, the chief executive of NHS Providers has said.

Chris Hopson told the Health Select Committee yesterday that nearly every member of NHS Providers is working on undeliverable plans to meet their 2020/21 financial allocation set by NHS England in May.

Hopson said members asked NHS England over the summer whether they could submit “any plan” that met the funding requirements or if a realistic plan that outlined “how far we can get” would suffice.

Hopson said providers were told they were “not allowed to submit a plan that doesn’t balance to that 2021 figure”.

He said: “So our members are saying to us that they are spending quite a lot of time creating plans that in their view are not deliverable and usually involve major structural service changes because that is the only way that they can create a balanced plan.

“Our view is that, that really risks blowing up and destroying a process that actually seems to us to have a huge amount of fundamentally positive benefits.

“And that is a consistent story that we’re getting from virtually all of our members.”

Hopson said that the challenge of balancing the books according to the “very reduced” funding allocation is compounded by the diminishing investment in the NHS by the Government.

The Department of Health announced in the NHS Spending Review that investment growth in the NHS would slow from a 1.3% growth in 2017/18 to 0.3% in 2018/19 and 0.7% in 2019/20.

Hopson described the figures as “scary” in parts of England that has STPs facing funding gaps of “hundreds of millions of pounds”.

He said: “What that means is people are coming up with vastly overambitious plans that either rely on vastly overambitious demand management plans or, more often, service reconfigurations.

“But to be frank they’re not going to happen because they won’t command the required political support and there simply isn’t the capital available.”

He added, however, that providers are not opposed to system reconfiguration to meet targets, but are looking for “a realistic stretch”.

Stephen Dorrell, chair of NHS Confederation, who was also giving evidence to the committee, added that STPs are “governed by spreadsheets”, making it more difficult for those involved to focus on the care and quality, and health and wellbeing gaps described in the Five Year Forward View.

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