Rhion Jones comments: –“If the report in GP online is true, there is an important debate occurring in NE London. NHS Managers seem to be saying that consultation is inappropriate on the STP (despite Ministerial commitments) because the plan’s content falls short of the ‘threshold’ for substantial change that entitles Health Overview & Scrutiny Committees to insist on public consultation. Councillors disagree and given the savings being made, it is difficult to see how the changes will be minimal.
But there is another statutory provision that says that there has to be involvement (probably meaning consultation in this context) over 1) the planning of commissioning arrangements – which STPs are certainly doing and 2) the development and consideration of proposals – which again the STPs are doing. It would be fascinating to see the legal advice that tells the Managers that they are not bound by this requirement.
But in any event, it is very poor politics – and bad tactics to forego the chance of taking the whole plan – which includes many welcome innovations and improvements – to the public, and instead to wait until the more contentious service changes or closures are proposed on a piecemeal basis.
Seeking the public’s endorsement of the plan as a whole would be far more valuable in setting the scene for further changes, and I’m puzzled that Managers do not see it in this light. Of course, we all know that engagement will vary from one part of the country to another, so there may be some specific London factors at work here, but the debate is important as I believe the NHS needs elected members to be comfortable with what is planned.”
ORIGINAL ARTICLE
Public consultation on an entire sustainability and transformation plan (STP) is impossible, NHS bosses have told London councils.
Leaders of the North East London (NEL) STP said there was ‘no suggestion’ the plan would be subject to consultation because it has not been proposed by a specific statutory organisation.
The comments appear to contradict an earlier statement by health secretary Jeremy Hunt, who told MPs in November he could ‘absolutely’ assure that there would be full consultation on STPs.
Speaking to the Inner North East London joint health overview and scrutiny committee on Tuesday, NEL STP’s director of provider collaboration Julie Lowe said: ‘There is no suggestion that the STP as a totality would be something that would be subject to consultation because it has not been brought by an organisation. So it would be a change within STP that would be considered for public consultation.’
STP consultation
The NEL official suggested that most reforms proposed in the area’s STP were unlikely to require consultation anyway. Ms Lowe said that only significant changes to services such as closures would be considered for consultation. ‘At the moment we are not consulting on anything because there are no proposals to do anything that would be meeting that threshold by quite a wide margin,’ she added.
NHS England has advised the 44 STP areas that formal consultation is required only where a substantial variation to service configuration, such as a hospital closure, is proposed.
But councillors on the scrutiny committee, which includes representatives from four boroughs and the City of London, raised concerns that the cumulative effect of the STP, which is seeking to close a financial deficit of £578m across the area over five years, could be considered significant.
GPonline has reported that NHS leaders behind the STP area planning for a 50% reduction in GP numbers in the area over the next five years.
Hackney councillor Ben Hayward told STP leaders: ‘The problem here is that you are dealing with such a huge amount and, you say it’s not talking about closing hospitals. Well, the Homerton [hospital] budget per year is about £270,000. You are talking about closing Homerton for two years… So when added together I think there may be a strong counter argument to say that it, in its cumulative effect would amount to a substantial variation on any local area.’
NHS funding
Waltham Forest councillor Richard Sweden added that councils should ‘be on the lookout’ for changes to services being ‘artificially split up, so that the smaller parts don’t represent any significant variation’.
NEL STP programme director Nichola Gardner added: ‘We are very committed to making sure that where there is change that requires significant changes to service we are committed to taking that through the formal consultation processes.’
But the STP’s director of communication and engagement admitted that ‘the whole notion of STP or what it’s about, hasn’t been communicated in an ideal way. And people haven’t felt engaged.’
Before the meeting local GPs and health campaigners called on councillors to follow the example of other local authorities and reject the STP. Dr Anna Livingstone said the NHS was in ‘complete crisis’, and the STP solution was forcing through ‘cuts plans’. She called on councillors to ‘say no to the STP’.
Terry Day from Waltham Forest Save Our NHS said the STP’s effective reduction in the number of hospital beds per head amounted to ‘planned neglect’.
Article originally published by GP Online
