News & Insights

Doctors’ broadside against NHS transformation plans – an Institute perspective.

 

 

 

 

 

A few days too late for the heatwave, the BMA held its Annual Representative Meeting this week in Bournemouth, and turned its legendary firepower on the Government’s STP plans.  One motion sought their demise because they had become ‘vehicles to try to legitimise further cuts to vital NHS services’. The BMA Chair is Dr Mark Porter and he claimed that the plans are about sustainability and transformation in name and name alone.

They were accompanied by aggressive Press Releases which were duly covered by the BBC.

On 28th June, the headline was A & E cuts will hit 23m people, British Medical Association says and accompanied by a map entitled “Where the axe could fall”. The calculation looked dubious to us, but it made for a good story.

http://www.bbc.co.uk/news/health-40416102

Around the same time, another story broke. Doctors ‘horrified’ by STP staff costs, which detailed a BMA investigation that revealed that new appointments or consultancy contracts to implement the STPs amounted to another layer of potentially wasteful bureaucracy in the NHS.

https://www.bma.org.uk/news/2017/june/doctors-horrified-by-staff-costs

 

Understandably, a key BMA message is that the NHS is desperately short of doctors and consultants and should not be spending money on business managers, finance directors or communications and engagement managers. One can see its point.

However, this same organisation has spent the last year complaining that there has been inadequate engagement and consultation. Another of its resolutions this week calls for “patients and the public to be consulted on realistic, evidence-based STPs”.

The truth is that if we wish to engage properly with, on average 1million + people in an STP area, it will need staff, it will need budgets, and if the plans are half-baked, the BMA will rightly complain and the exercise will, as some Doctors argue be a waste.

It must be hard for clinicians under pressure to see radical changes being considered and for cherished services to be under threat. But our experience is that a well-run consultation plays a big part in avoiding mistakes. An exercise that starts with Managers – and clinicians -thinking through the options properly and avoiding coming to conclusions before engaging professionally with local stakeholders, patients and the general public can be immensely powerful in harnessing local creativity and innovation and finding new solutions.

The trouble is that public engagement is not free of cost. The Lansley reorganisation in England led to half the experts who worked on community relationships in the Primary Care Trusts losing their jobs, and the STPs are having to rebuild some of the expertise that the NHS foolishly discarded. At the very time when local authorities, the BMA, The Kings Fund, Members of Parliament, and virtually anyone else who knows about STPs are crying out for better public consultation, there are fewer ‘boots on the ground’ who have experience of organising these challenging engagement projects. Happily, in The Consultation Institute, we have been able to support a number of them and guide them towards cost-effective, best practice. But that makes us part-targets of the BMA’s Bournemouth broadside, and we would prefer to persuade doctors that it is in everyone’s interest – and in theirs – that the public be fully involved and professionally consulted on important changes to the NHS.

 

 

Rhion Jones

Founder Director

The Consultation Institute

 

 

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