A secret process to cut and further privatise NHS services is charging ahead across England. It goes under the name of Sustainability and Transformation Plans (STPs).
England has been divided into 44 Sustainability and Transformation Plan ‘footprints’ which must make huge spending and service cuts and increase NHS privatisation in order to access “transformation” funds.
STPs are being drawn up in conditions of secrecy imposed by NHS England. 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.”
If you think this is a VERY BAD IDEA, please protest outside Halifax Town Hall at 9.30am, before the Calderdale Health & Wellbeing Board meets at 10am.
This meeting is to decide whether to agree to the recommendations of their private meeting on 11 August – when they heard a presentation from Calderdale Clinical Commissioning Group about the West Yorkshire Sustainability & Transformation Plan and the Calderdale Sustainability & Transformation Plan.
Neither STP is available to the public – nor are the minutes of the private meeting, which was not on the Calderdale Council calendar of meetings.
Tell the Health and Wellbeing Board:
- NOT to accept the recommendations of their private meeting on 11 August
- BUT instead to immediately publish:
- the West Yorkshire “checkpoint” Sustainability and Transformation Plan which was sent to NHS England on 30th June;
- the current draft of the Calderdale STP and the current draft of the final West Yorkshire STP – the final version is due to go to NHS England in October
- AND to immediately submit these draft STPs to scrutiny by the Adults Health & Social Care Scrutiny Panel.
STP requires our hospitals Trust to make massive extra cuts
Under the STP financial rules – snuck out by NHS England at the end of July after Parliament went on holiday – Calderdale and Huddersfield hospitals Trust must more than halve its planned deficit this financial year – from £40.5m (only achievable after making £14m efficiency cuts), to a “control total” deficit of £16.153m.
How the hell is it going to do this? What else will it have to cut – beyond the planned £14m “efficiency cuts”?
In return for this, the hospitals Trust is to receive £11.3m Sustainability and Transformation Funding from NHS England in 2016-17.
More than halving the deficit is not the only condition attached to the STP Funding; there are others, and penalties for not meeting them are dire.
At least one of the conditions seems unachievable: that Calderdale & Huddersfield hospitals Trust (CHFT) must have a recovery plan in place that shows when they will break even, within a reasonable timeframe.
But the hospital cuts pre-consultation business case shows CHFT in deficit for at least the next decade; and no one during the public consultation drop ins was able to say at what point beyond 2026 CHFT might break even.
Matt Walsh, the Calderdale Clinical Commissioning Group’s Chief Officer, told the Governing Body meeting on 11 August that that he doesn’t know the detail of Sustainability and Transformation Plan discussions between NHS Improvement, NHS England and CHFT – but the Clinical Commissioning Group’s position is that it will uphold NHS constitutional standards, but will report more throughout year.
The NHS Constitution says that patients
“have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you.”
And it sets time limits for having operations and receiving care, eg the 4 hour standard for receiving A&E treatment.
Calderdale NHS Commissioners to discuss denial of treatments
How will Calderdale CCG meet its commitment to uphold NHS Constitutional standards, when Matt Walsh recommended to the same Governing Body meeting that the CCG should start “having conversations now to secure the financial position this year”, through restricting treatments – such as:
- only allowing one outpatient follow-up after an elective operation
- stopping prescriptions for self-limiting illnesses and for vitamins, food supplements and gluten-free products
- cherry picking patients for medical and surgical interventions that are “procedures of limited clinical value”
What is on Calderdale CCG’s list of Procedures of Limited Clinical Value? We need to know.
According to the Royal College of Surgeons,
“ ‘Procedures of Limited Clinical Value’ (PLCV) is a term NHS managers have applied to a range of elective surgical procedures that they no longer wish to fund…[B]ecause of the current financial restrictions,…many proven operations known to enhance health and improve quality of life have been included in this category, and hence are being denied to patients who need them.”
The Royal College of Surgeons have roundly criticised such denial of treatment, where it has occurred.
Matt Walsh told the cash-strapped Clinical Commissioning Group’s Governing Body that that NHS England’s STP “financial reset” document sends the message to failing systems that:
“if we don’t deliver what is called for, others will come in and do it for us”.
He said it is very clear statement about NHS Improvement and NHS England actions for what will happen to failing CCGs.
He told all Governing Body members they must read the “financial reset” document and that
“…the Finance and Performance Committee needs to produce the CCG’s response to the financial challenge and bring it back to the Governing Body.”
There were NO COMMENTS or questions from the Governing Body. They seemed dumbfounded.
The effect on our NHS is going to be severe. Calderdale and Kirklees Save our NHS campaigners vehemently oppose this dogmatic policy which will put lives at risk – and the secrecy with which it is being imposed.