HSJ’s round-up of the must read stories from Friday
It’s time to publish the STPs
It was waiting to happen, wasn’t it? The general media was awash on Friday with reports of “alarm at NHS plans for closures and cuts”, as details of what is being put into some sustainability and transformation plans has spilled into the public domain, fuelled by campaign group 38 Degrees.
“Not unfair”, you might argue, given the compromises that are having to be made under severely constrained budgets.
But Friday’s stories seized on some odd examples: rationalisation plans for hospital sites in Leicestershire and the Black Country that had been in the public domain for years – and in the case of the latter, a suggestion that a hospital that is still being built was going to lose its A&E (it isn’t).
Of course there will be controversial stuff in the STPs – when is there not in NHS strategic plans? – but in some cases reconfiguration plans will, like these, already be socialised in the local area.
Where there are difficult decisions to announce, delay and obfuscation seem to be doing little to help, as Friday’s coverage illustrates.
Concern about what is going on with STPs is being exacerbated by unnecessary secrecy, encouraged by the centre and irritating to most STP leaders, who want to get on and publish them.
Several areas have more work to do, particularly on the gory detail of impact on “heads and beds”, while national officials would like to retain a power of veto to demand changes. But time is running out fast and, for the majority, no huge rewrites are going to happen by the 21 October deadline.
Space needs to be found in what is an intensely tight planning timetable for STPs to be published, and to be signed off by NHS boards and health and wellbeing boards. Not only would this allay suspicion and give the process some legitimacy – it would also, critically, help tie all the players into delivering them.
Edward Cornick, a financial policy adviser at NHS Providers, has run the rule over Thursday’s Q1 performance figures, which showed the provider sector had a deficit of £461m for the first three months of 2016-17 – £5m better than planned.
While “the headline figures seem to suggest the regulator has had success in slowing the deficit”, he says “having a provider sector that far in deficit after only three months of the year should be nothing to shout about”.
He writes that the financial control measures taken by NHS Improvement “have managed to slow the runaway train” of provider deficits, but it is too early to know if “the brakes applied to the train have really worked”.