5 January 2017
The Green Party in Yorkshire and the Humber have come out against the contentious NHS Sustainability and Transformation Plan (STP) contracts for 2017-19 that will see over £1 billion of Government cuts from Health & Social Care Services by 2020/21.
PHOTO: Greens and allies protest the coming £1 billion cuts from one STP area alone. Stop the STPs protest outside Quarry House, Leeds, 23rd December.
These contracts will deliver huge cuts and changes to NHS and social care services - but both the public and frontline NHS staff are in the dark about where these cuts and changes will fall, such is the secrecy of the 2017-19 STP operational plans.
On 23rd December, Save the NHS campaigners Jenny Shepherd, Christine Hyde and Paul Cooney tried to deliver a letter to the NHS England office, signed by over 1,000 members of the public, to the NHS England office in Leeds. The letter called for the immediate resignation of the Chair and Members of the Board of NHS England. However no one from NHS England was willing to accept the letter.
Major NHS threats
Yorkshire and the Humber Green Party supports Stop the STP campaigners who are calling for a halt to the contract negotiations, in order to stop the 44 area Sustainability and Transformation Plans before they:
• SLASH £22bn-£30bn FUNDING from the NHS by 2020/21 compared with current levels of provision - plus huge social care funding cuts
• RESTRICT NHS TREATMENTS and cherry-pick patients whose treatments will provide value for money - abandoning the core NHS principle that its treatments are equally available to all who need them
• END PUBLIC OWNERSHIP of the NHS by bringing in profiteering private companies, with the aim that by 2020/21 50% of NHS services are provided by public-private partnerships & the private sector match funds public funding for the NHS
Just one STP aims to cut £1 billion from the area
The West Yorkshire and Harrogate STP, if implemented, aims to cut over £1 billion from NHS and social care budgets by 2020/21, compared to what needs to be spent to maintain current levels of both services.
NHS England - the government’s NHS commissioning quango, and NHS Improvement - the NHS Trusts’ regulator - aim to achieve this by imposing a harsh financial control across the whole region and making all the NHS organisations mutually responsible for keeping their spending within this limit.
This is already destabilising both hospital trusts and clinical commissioning groups, which are unable to meet their statutory requirements for patient care while sticking to the financial controls.
The Leeds section of the West Yorkshire & Harrogate STP makes the shocking admission that: "Our services will provide a minimum 'universal offer' but will tailor specific provision to the areas that need it most."
“This is a total departure from the principle of a comprehensive NHS. What happens to patients who need more than the minimum universal offer but aren't judged to be eligible for any more than the universal minimum?” – said the Green Party’s Jenny Shepherd.
Calderdale CCG facing cuts under STP regime
Already Calderdale Clinical Commissioning Group is in so-called “financial turnaround” as a result of harsh STP financial controls - meaning it faces having a private sector consultancy company parachuted in to tell it what to cut.
Councils face further healthcare cuts from STP too
The governance systems needed to impose these region-wide financial controls are not even in place and Councils protest that they are not included in the decision making bodies, despite the fact that their social care services - already massively underfunded and facing more cuts through the STPs - are meant to be integrated with NHS services and rely on the STP to transfer significant funding from the NHS.
1. NHS England’s and NHS Improvement’s instructions to CCGs about the 2017-19 contracts are in the so-called STP financial reset document issued in July 2016: Strengthening Financial Performance and Accountability in 2016-17 - https://improvement.nhs.uk/uploads/documents/Strengthening_financial_performance_and_accountability_in_2016-17_-_Final_2.pdf
“Once we have completed the 2016/17 ‘financial reset’ it is vital that we move on swiftly with operating plans which deliver on the visions agreed within STPs.
Final STP Delivery Plans, to be submitted in October by each footprint, will set out how individual organisations will play their part in delivering their locally agreed STP objectives, including sustainable financial balance across the health economy. Delivery plans will form the starting point for two-year, organisation level operating plans for 2017/18 and 2018/19, with collaborative actions across local health economies supported where appropriate by system control totals.”
System control totals are financial limits that NHS England is imposing across the STP “Footprint” area from 1 April 2017. It means that individual organisations may no longer control their own budgets if the STP Board (or whatever STP governance process is in place) decides that in order to meet the system control total, an individual hospital or other NHS organisation has to make cuts or changes.
2. The Green Party of England and Wales is committed to defend the NHS against cuts and privatisation and to stop the Sustainability and Transformation Plans
An emergency motion passed at the Autumn 2016 Conference committed the Green Party of England and Wales to support local campaigns campaigns and protests against the 44 area “footprint” “Sustainability and Transformation Plans”, that have been drawn up in conditions of secrecy imposed by NHS England.
The motion noted that:
• NHS Improvement has instructed NHS organisations to list services which could be axed or centralised, making “rapid progress” during the current financial year.
• A host of local campaigns across England sim to protect and reinstate full acute and emergency services at district general hospitals, and to protect other NHS services from cuts and privatisation.
• The secretive preparation of Sustainability and Transformation Plans, which only came to light a few weeks before the September Conference, is an appalling abuse of our democratic rights and is being met with protests at local authorities’ Health and Wellbeing Boards, Clinical Commissioning Group meetings and the offices of NHS England – all organisations with a role in the development and implementation of Sustainability and Transformation Plans.
3. There is NO financial detail in the published West Yorkshire & Harrogate STP, or information about the 2017-19 STP operational plan. There is no way of knowing what the contracts, due to be signed off on 23rd Dec, will entail - although it is clear from the West Yorkshire & Harrogate STP that the intention is to make rapid changes in 2017-2019, before the Sustainability and Transformation Funding peters out in the last two years of this Parliament.
4. Information about the £22bn-£30bn NHS funding shortfall by 2020/1 comes from various sources. NHS England’s Five Year Forward View 2015/16 - 2020/21 stated the NHS faced a £30bn funding shortfall https://www.england.nhs.uk/wp-content/uploads/2016/05/fyfv-tech-note-090516.pdf. This was revised down to £22bn after the Conservatives promised an extra £8bn NHS funding by 2020/1 during the election. The 2015 Autumn Comprehensive Spending Review committed an extra £10bn NHS funding - but this year the Health Select Committee identified that only £4.5m of this is new funding, with the rest taken from other bits of the NHS budget. An analysis by the Nuffield Trust shows that once cost inflation for drugs and new NHS treatments is taken into account, this is only worth around £800m. http://www.nuffieldtrust.org.uk/blog/behind-numbers-nhs-finances
5. Information sources about restrictions on NHS treatments, cherrypicking which patients to treat and inability to meet statutory requirements:
Calderdale Clinical Commissioning Group Governing Body meetings - Chief Officer’s Reports, 11 August 2016, 8 Dec 2016.
Mid Yorks Trust Board Meeting papers 3.11.2016.
6. Information source about Calderdale CCG being in turnaround: Chief Officer’s report to Governing Body Meeting, 8 Dec 2016.
7. The West Yorkshire & Harrogate STP aims to transfer significant amounts of supposedly ring fenced NHS funding to Councils' social care budgets. Page 20 of the WY & Harrogate STP shows that it can only reduce the £1.07bn funding shortfall by £983m by 2020/1. It can not eliminate it. The 2020/1 “deficit” or underfunding will be £91m - made up of an NHS surplus of £43m and a £135m social care underfund. So NHS money - supposedly ringfenced - is going to be diverted to prop up local authorities that the government has starved of funding. The WY&H STP p 20 adds that local authorities are statutorily required to break even and the STP are trying to work out “how to mitigate this pressure”.