The King’s Fund has flagged up concerns about the Sustainability and Transformation Plans (STPs), which are being drawn up for each area of England. These will see major changes to health services, including potential hospital cuts and closures, and well as more joined up working between health and care sectors.
In Cumbria the STP, which will be formally published in the coming months, is further on than most.
The Government’s Success Regime is already consulting on controversial plans to cut hospital services and beds across north, east and west Cumbria – prompting the launch of the News & Star Save Our Services appeal, backed by more than 3,000 people to date.
Once finalised, its plan will form a key part of the STP, as part a wider vision for local health and social care.
But campaigners fighting the Success Regime cuts claim concerns flagged up by the King’s Fund show there are serious flaws in the ongoing consultation process.
Local bosses stress that the situation is “a little different” in Cumbria, as work has been ongoing for some time already.
But protesters disagree. They say the national picture shows that, despite bosses consistently saying the changes proposed in north and west Cumbria are not about money, it is financially driven.
The national body’s key findings include:
- Despite the focus on local ownership, key elements of the STP process have been ‘top-down’
- The approaches of national NHS bodies and their regional teams have not always been aligned
- Tight deadlines have made it difficult to secure meaningful involvement from key stakeholders, including patients and the public, local authorities, clinicians and other frontline staff.
One of its key recommendations is to ‘stress-test’ STPs to ensure that the assumptions underpinning them are credible and the changes they describe can be delivered – something campaigners argue has not been done by the Success Regime in Cumbria.
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The King’s Fund also calls for more meaningful local involvement and urges NHS chiefs to focus on the skills and resources needed to implement STPs – again issues raised locally.
Researchers, who spoke to those involved in several STPs nationally, said there were signs that services were being centralised at a smaller number of hospitals, as proposed here. And they warned that although there was an opportunity to improve care, the process had increasingly become financially driven in recent months.
The report also states that some leaders: “felt that STPs had ‘created an industry’ for management consultants – and questions were raised about why money is being invested in advice from private companies instead of in frontline services”.
Jane Mayes, from Alston, is among those fighting to save their local community hospital beds, as well as opposing wider cuts to health services across north and west Cumbria.
She said the report fuels their criticism of the Success Regime and its ongoing consultation. “It’s obvious that this is our STP. It is being tried out here as one of the early ones,” she said.
“This is exactly what we’ve been saying – that this isn’t a meaningful consultation. A respected body like the King’s Fund is now saying the same thing. We are one of the early ones and the consultation has been flawed. I think the Success Regime will find that they have made a mistake with the way they have run this.
“There is talk of a top down approach – that applies to us absolutely. We feel that these people, who mostly seem to be management consultants and PR companies, have stepped in from outside and are trying to do something that doesn’t fit. A plan has been worked out, distances have been measured on a map, groups of around 20,000 people have been arbitrarily designated as communities all without reference to the realities of a mountainous rural area with millenia-old patterns of settlements and roads.
“They say the STPs now need to be stress-tested. I would agree with that entirely,” she added.
Chris Mitchell, a hospital campaigner from Penrith, added: “Everything in the report from King’s Fund – lack of effective engagement and decisions being taken before consultation – is true of Success Regime to date. This is all about money.”
But Stephen Eames, the chief executive of north Cumbria’s hospitals, who is also leading the STP locally, said the situation is different here to other parts of England because the area was already under the Government’s Success Regime, set up to tackle problems in the local NHS with all the local health trusts working together.
“We are currently consulting our community about the plans we have developed to ensure that services are safe and sustainable into the future,” he said. “I would urge anyone who wants to have a say about the services to take part in the consultation before December 19. The STP is being developed alongside this process and will continue to develop from the public consultation.”
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