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NHS England statement on Sustainability and Transformation Plans

Commenting on stories today on local Sustainability and Transformation Plans, a spokesperson for NHS England said: “We need an NHS ready for the future, with no one falling between the cracks. To do this, local service leaders in every part of England are working together for the first time on shared plans to transform health and care in the communities they serve, and to agree how to spend increasing investment as the NHS expands over the next few years.

“This is a unique exercise in collaboration. It is hardly a secret that the NHS is looking to make major efficiencies and the best way of doing so is for local doctors, hospitals and councils to work together to decide the way forward in consultation with local communities. Proposals are at a draft stage but we expect all local leaders to be talking to the public and stakeholders regularly – it is vital that people are able to shape the future of their local services.

“No changes to the services people currently receive will be made without local engagement and, where required, consultation. There are longstanding assurance processes in place to make sure this happens.”

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32 comments

  1. Kassander says:

    ​​Citizen Singh’s Revolution set to devour its own Citizens #1
    ——-
    This unnamed spokesperson for NHS E makes a number of interesting claims about involvement, consultation and working together on STPs
    S/he clarions the unspecified ”… longstanding assurance processes in place to make sure this happens”
    ​Not ones I’ve seen in operation, and the assurance, wherever it is, is doomed I say, doomed​
    * CCGs select, and pay handsomely, their selection of Lay NEDs to represent P&Ps
    * As a consolation / booby, prize, CCGs have set up People’s Boards – membership selected by the CCGs
    * Representatives of the P&P on other Boards and committees are drawn mainly from just TWO sources:
    The ‘Voluntary’ sector – now subcontractors to NHS and other NHS service providers
    The growing band of self declared ‘Patient Leaders’ :
    Elected by no one
    Reporting back to no one​
    Accountable to no one
    Now set up in business to ‘train’ other unaccountable Patient Leaders
    But matters are set to get even w

  2. Kassander says:

    ​Citizen Singh’s Revolution set to devour its own Citizens #2
    Anu Singh, now calling herself Director of PPPI has, following a barrage of protests, finally published the highly hush, hush​ ​Agenda for the Workshops on 12th Sept​​ ​so​​ ​Citizens​ ​might discuss the future of the £2m +, Gather project​ ​which​ ​was​​ ​closed overnight by Citizen Singh, with​ ​no​​ ​consultation with
    ​its​ 3 000 members
    The format will be three of our Betters telling US about THEIR determination​ ​​(Tabled?) ​of how WE will be allowed to express OUR opinions about THEIR selection of aspects of OUR NHS
    To ensure that there is no opposition, the notice convening the handing down of the tablets of stone is accompanied by FOUR pages of draconian rules governing the running of this meeting and soon all NHSE meetings
    It even contains a dress code​ ​NO​ sloganizing T Shirts​?​
    Ctzn Singh’s briefing @ Expo 16 will be the LAST chance to wear those T shirts, and raise a voice of protest.
    See you there, Citizens

  3. Kassander says:

    ​Citizen Singh’s Revolution set to devour its own Citizens #2
    Anu Singh, now calling herself Director of PPPI has, following a barrage of protests, finally published the highly hush, hush​ ​Agenda for the Workshops on 12th Sept​​ ​so​​ ​Citizens​ ​might discuss the future of the £2m +, Gather project​ ​which​ ​was​​ ​closed overnight by Citizen Singh, with​ ​no​​ ​consultation with
    ​its​ 3 000 members
    The Agenda will be three of our Betters telling us about their determination​ ​​(Tabled) ​of how we will be allowed to express our opinions about their selection of aspects of OUR NHS
    To ensure that there is no opposition the notice convening the handing down of the tablets of stone is accompanied by FOUR pages of draconian rules governing the running of this meeting and soon all NHSE meetings
    It even contains a dress code​ ​NO​ sloganizing T Shirts​?​
    Ms Singh’s talk @ Expo 16 will be the LAST chance to wear those T shirts, and raise a voice of protest.
    See you there, Citizens

  4. Carol Hunt says:

    With many CCG’s under serious financial pressure with warnings of ‘Special Measures’ by NHS England I fear any STP is going to include many drastic cost cutting measures. The heavy weight of efficiency savings in all departments will add to this. As contracts are put out to tender the private sector will cherry pick the profitable services. The remainder including the long term sick and the elderly will no doubt be in the hands of NHS services. The doctors and nurses delivering these services will be, as currently witnessed, under enormous pressure to deliver safe, effective care offering a positive patient experience in an under resourced, pressurised environment. The unfavourable decisions having to be enforced by Management in line with Government directives are so contentious they are not going to be shared with the general public. No additional funding is going to be available to health services without additional taxation or private health insurance to support NHS costs.

  5. Francesco Palma says:

    Over 20 comments on STP Plans quite a high number for a comments on this website for a piece from a spokesperson from NHS England.
    Moderator please make FYFV SRO aware of these comments please as little support from patients,public,service users and carers is assured due to lack of engagement & Consultation.

  6. J says:

    So secret as to be sinister. Profit before patients in an NHS cut to the bone! The sooner Stevens and Hunt fall through cracks the better!

  7. Lorna Goldman says:

    Efficiencies? This isn’t about efficiencies, or quality of patient care, this is about privatisation of the NHS

  8. Paul Cooney says:

    STPs are being drawn up in conditions of secrecy imposed by NHS England – as their North Midlands Director of Commissioning Operations, Wendy Saviour, told a recent meeting of Shropshire Clinical Commissioning Group:

    “STPs are not meant to be published at all. They should not go to Board meetings. Some of them contain very radical things… These are highly political and highly contentious. Once they’re washed off and the national messages are gathered together, they will be published.”

  9. Graham Noble says:

    It seems to me we need a twofold stately.
    Firstly we need to put more money into the system in order to maintain a very strained system, in the relative short time.
    Secondly we need to put big resources into changing the culture that sees so very many of us relying on the NHS to sort out the problems caused by our own chosen lifestyles.
    In the short term this is going to be a costly venture.

    • Suzi Mae says:

      Graham can you define chosen lifestyle please?

      • Kassander says:

        Many people’s ‘chosen lifestyle’ includes having to live in substandard housing, next to a main road where vehicles pump out noxious fumes 24 hours a day.
        They also ‘chose’ to work on Zero hours contracts and have to spend substantial amounts of cash on less than convenient public service trasport to get to and from those places of work in the middle of the night.
        Oops, did I write ‘Service’ ?
        What I meant was A state subsidised profit centre.
        Yes, the onus is on these people to sort out their own problems – and one way to do it is to join an organization which will throw out the present gang of Mamon-ites in power both in Parliament, and NHSE.

  10. Nora Everitt says:

    I see my comment posted on 27th August is not published as it was critical.
    Recent posts also mentioned the lack of public involvement, as I did, and the non-statutory status of the new decision-makers that agree the Vanguard recommendations, the STP (plans) and the STP budgets soon to be submitted.
    The statutory local planners, the CCGs, are being sidelined and decisions made by partnerships that include both ‘purchasers’ (commissioners) AND ‘providers’ bringing massive conflict of interest considerations.
    The boundaries between ‘legal authority’ and ‘policy driven’, together with ‘commercial interests’ and ‘commissioning responsibilities’ are becoming very blurred.
    The pace of change is increasing, with a focus on keeping within budget taking little account of increasing demand for services as conditions develop in an aging population.
    The NHS belongs to all of us and it is essential that services and service planning are accountable to the public. We, the public all rely on our NHS.

    • NHS England says:

      Dear Nora,
      We moderate all comments posted to our website before we publish them and we try and do this as soon as possible but only during working hours. As your original comment was submitted on a Saturday, which was then followed by a bank holiday Monday, your comment was published today. Please see our comment moderation policy for further information: https://www.england.nhs.uk/comment-policy/
      Kind regards,
      NHS England

  11. Barbara Martin says:

    Everybody in North Devon objects to making our remote part of this county unsafe by making cuts to our hospital. How do we become part of this consultation process ?

  12. Rudy Tambala says:

    Speaking as a service design and digital transformation consultant, specialising in healthcare, I am pleased to see that the initiative is there, in idea at least. However, a basic feature of good service design is co-creation; the service should be designed by the service users, service deliverers, AND the service designers. Consultants such as I are rarely invited to the the table, and years of expertise and experience, in transforming almost every other consumer industry – e.g. air travel, retail, entertainment, media, banking … – is not being applied, except as maybe as an afterthought. Personalisation (Personalised care), Customer-centricity (patient-centricity), functionally integrated service ecosystems (integrated health), and so on – these are the everyday bread and butter of service designers – CCGs need to open up and reach out, in order and learn from our experience, and enjoy the myriad benefits enjoyed by other industries, that may help to save our NHS.

  13. Dr Ray Travers says:

    If quality of care is not to suffer, and with rationing unacceptable, it is inevitable that the emphasis must be on greater productivity and efficiency. STPs (plans to rationalise and integrate services across geographical areas, centralisation of specialist care and the pursuit of innovation and reduction in variations in care are all understandable in this context.

    I agree with the point that transparency of such processes is essential. My main concerns lie elsewhere. I am not convinced that the various stakeholders share the same values and hence the implicit assumptions underpinning the current ‘conversations’ especially mutual respect and trust are lacking. I worry that the stakeholders have different perspectives on the desired ‘outcomes’ that will restrain system wide improvements.

    Working in mental health, my immediate concern is that NHS England has little interest in mental health due to the urgency of addressing the financial deficits post the 21 July “reset” plan.

  14. ernie o' grady says:

    To HELP the n.h.s. everyone who works could pay an extra pound a week, and if you don’t work, you pay a smaller amount after all we ALL need the n.h.s. I don’t think people can kick-up over that, or the n.h.s. will go under. Also look to the ( TOP ) FOR cuts I am sure you will find some cuts at the top.

    • Suzi Mae says:

      I am sure they could also find lots of money from avoided and evaded taxes too, we are talking about huge amounts of money. You know all those people getting more obscenely rich, rather than all those poor getting obscenely poor!

      Oh and all the money we are saving by coming out of the EU as promised by the battle bus?! Or was that not true?

      Then of course there is the political will to fund health care instead of wars! Nye Bevan was minister of health and housing the two go hand in hand and I think you will agree a happy, stable , well looked after society is a much more stable and productive one.

      Living conditions are causing many health issues both physical and mental which ultimately impacts on our NHS..

  15. Gordon (gus) Cairns says:

    NHS England should have more power to make the area STP Boards include Patient and public Involvement in their local STP’s . In my area all talk of STP’s is in Part 2 of meetings of CCG’s FT’s and Council Health and Wellbeing Boards which excludes the general public stakeholders .It just adds to suspicion that major cuts in Hospitals and services are being planned behind our backs in secret enclaves to run the NHS into the Ground and get it ready for selling off to Private foreign Health Firms and medical insurance Companies which are Hunt’s Friends . I think if this happens there will be picketing of hospitals to stop a two tier health service being foisted upon us . in Fact we already have a two tier Health Service with those who can pay jumping the queue into private hospitals and the rest of us waiting in ever lengthening queues for our procedures and being cancelled several times and then told all operations for planned procedures are cancelled till April .No Money

  16. Janet Gardiner says:

    Please can you let me know where I can see records of the progress of STP’s and where they stand at present? If this is not available for the public (as I am led to believe) can you confirm when the information will be available and that it will be revealed before decisions are made, thus giving the public a chance to influence the plans? I live in the East Devon area.

  17. Mark Tiston says:

    How is this to happen if there is not any mechanism in place to ensure that the assurance about public engagement translates into a reality.
    CCGs are not engaging the public at appropriate stages of the STP design and GPs appear to be silent regarding their crucial role of co-ordinating the ACPs.

  18. John Davies says:

    and where required consultation WHERE REQUIRED
    This sinister and secret attempt to privatise the NHS is being done with no Parliamnentary approval The SPT apparently because it is non statutory has not requirement for consultation We do not need consultation we want abolition of this further Neo Con stitcj
    And how come Richarda Branson keeps getting contracts without having to bid !

  19. Gordon Cairns says:

    You mention local people and stakeholders being involved in the plans but no one has seen any plans as far as I know

  20. Geoffrey Smith says:

    It is a pity that the strict requirements NHSE imposed for secrecy during the development of STPs may have undermined public trust and confidence, and so could make the engagement and consultation process more difficult.
    Geoffrey Smith

  21. Maurice Neville says:

    Given that the STP process began last December and so far the vast majority if NHS and LA participants have given out close to zero public information, let alone engaged in any public participation whatsoever, I take leave to doubt the sincerity of this ever so fluffy statement. As to the use of the phrase ‘as the NHS expands over the next few years’ ……. even my cat laughed.

  22. Nora Everitt says:

    So – no service changes without local engagement because ‘there are longstanding assurance processes in place to make sure this happens’.

    Really? I think this year, 2016/17, NHS England has disregarded these longstanding assurance processes.

    NHS England and CCGs both have statutory duties to involve the public in service planning and commissioning decisions.(Health & Social Care Act 2012 sections 13Q & 14z2)

    This year, 2016/17, NHS England closed down NHS Citizen, a national public involvement website. They published an annual report, which has to include in it how they met their own legal duty to involve the public, but only described how they agreed some policies saying how they ‘intend’ to.

    NHS England’s CCGs’ Assurance process, this year, left out the patient and public involvement measures.

    This year, the ‘long standing assurance processes in place’ for NHS England’s and CCGs’ legal duties to involve the public in service changes were removed or ignored.

  23. Francesco Palma says:

    Dear NHS England
    I provide the link below to the letter(Gateway Reference 04820)which informs that STP Plans should be subject to discussions with communities, staff and other partners. this has not taken place.
    It would appear that the FYFV People and Communities Board has not been influential in ensuring the the one of the 6 principles of the FVFV/New Models of Care namely empowering people and communities and the FYFV core value of Patient Involvement has been assured locally,the carrot on the end of the stick a share of the £1.8 billion in 2017 for the 44 STP’s would suggest that you NHSE are centrally driving a local agenda and taking no responsibility to engage with people and communities to ask/consult with the population but then nor is the CCG’s involved with the STP’s
    Time to act please.

    https://www.england.nhs.uk/wp-content/uploads/2016/02/sustainability-transformation-plan-letter-160216.pdf

  24. Save Good Hope's Local Services Campaign Team says:

    There is in fact no transparency and there absolutely needs to be.

  25. BBC should be awarded a Gold medal for exposing NHS England plans for “rationalisation ” of services . The front line staff will do the unpleasant task on behalf of the austerity-stricken politicians and their underlings.
    How about direct conversations with the electorate, Mr J. Hunt ? You didn’t have your fingers burnt with our courageous trainee doctors, did you ?

  26. Michael Vidal says:

    I note what the staement says, however, this seems to contradict what I have been told locally. Whenever STP’s have appeared on my local CCG’s board papers amongst the updates are words to the effect that the palns are in draft and should not be discussed in public. My local CCG thankfully ignores this and discussions are done as Part 1 business.

    If STP’s are to be successful there needs to be open and genuine discussions of the draft STP’s the only way this is going to happen is if NHS England gives clear guidance that the plans must be discussed and developedwith patients and staff who are to have input into the STP.

  27. Francesco Palma says:

    STP Plans already submitted without engagement and consultation at the end of June.
    NHSE Guidance required Patient & Public Involvement but this was not assured by NHSE.
    I would suggest that NHSE assures itself by requesting statement of declaration from PPI lead and confirm by community representatives for each of the 44 STP footprints that F2F engagement had taken place before releasing STP funding in April.
    2017.
    Although this is a local plan it is driven centrally by NHSE, avoid the possible future legal challenges and do the right thing allow the STP community/population to share with commissioners the challenge of maybe having to make hard decisions.