STPs are making plans 'they do not believe can be delivered'

Chris Hopson, chief executive of NHS Providers, told the Commons health committee that financial requirements placed on “sustainability and transformation plans” are leading to “vastly over-ambitious” proposals.

STPs are currently being drawn up in 44 patches covering England, many having to deal with huge financial deficits over the next five years, and severely constrained funding growth under the comprehensive spending review settlement announced last November.

Mr Hopson told the committee that the “financial gap” in many STPs totals “hundreds of millions of pounds”, and added: “They are now looking at a set of figures that to be frank just look completely undeliverable.

“Our members very clearly asked the question in June and July, ‘Do you want a plan, any plan, that balances to that very reduced figure or do you want us to tell you how far we can get?’

“And the answer came back very clearly, ‘You are not allowed to submit a plan that doesn’t balance to the 2020-21 figure’.

“Our members are saying to us they are spending quite a lot of time creating plans that in their view are not deliverable and usually involve major structural service changes because that’s the only way they can create a balanced plan.

“And our view is that actually that really risks blowing up and destroying a process that actually seems to us to have a huge amount of fundamentally positive benefits. And that’s a consistent story we’re getting from virtually all of our members.”

He said the plans are deemed overly ambitious because “they won’t command the required political support and there isn’t the capital available”.

He stressed that trusts believe they can do more to deliver efficiencies, but want “realistic targets”.

Stephen Dorrell, chair of the NHS Confederation, told the committee that the STPs are “governed by spreadsheets” which make it “much more difficult for the partners within the process to deliver the objectives for which the STP process itself was set up”.

He also called for greater political engagement in the process at a national level.

Earlier this year HSJ analysed the financial health of each STP area.

Asked whether there had been any indication the government would grant extra funding for the NHS in this year’s autumn statement in November, Mr Hopson said: “The indication so far is it’s extremely unlikely that the NHS will receive any extra revenue. However the door appears to us to be slightly open that if the NHS could come with a proposition that would form part of the infrastructure fund investment - ie capital - then there might be an opportunity.”