HCSA report gives a hospital doctors' view on STPs

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HCSA has today today urged policy-makers to heed their concerns over Sustainability and Transformation Partnerships as it releases a new report reveals the struggle STPs face winning over the profession.

The report, “STPs: Destined to fail or the road to better care?”, highlights the structural barriers that have prevented medical scrutiny of the plans.

Doctors based in Trusts across England took part in research by the Association, which highlighted a string of fundamental issues with the plans, which HCSA General Secretary Eddie Saville said led to a process that is “too fast, too vague, underfunded and displaying the classic symptoms of policy failure.”

Research by the Hospital Consultants & Specialists Association, the only professional association and trade union dedicated solely to hospital doctors, reveals overwhelming scepticism among medical staff, and a near total absence of the clinical scrutiny required to ensure patient care is protected.

  • 95 per cent felt they had not been consulted nor had sufficient involvement in the process
  • 77 per cent believe that STPs are a measure to introduce cuts to the NHS
  • 62 per cent expect STPs to have a “negative impact” on the delivery of care to patients

Alongside its findings HCSA has launched proposals aimed at adapting STPs to shift the focus onto better, more integrated care.

HCSA Chief Executive Eddie Saville said: “The overwhelming message from hospital doctors is that STPs, on the evidence so far, pose a fundamental threat to services. The process is too fast, too vague, underfunded and displaying the classic symptoms of policy failure.

“Despite this, there is still now an opportunity to turn things around. What we’re saying is let’s slow this process down, let’s pause for breath and really look at the resources required to avoid damaging service cuts.

“Proper clinical scrutiny must be hardwired into the process if we are to salvage the potential benefits of STPs - joined-up care and a positive transformation of services.

“HCSA's recommendations hold the key to unlocking STPs’ potential in the long term rather than seeing them become another damaging, failed and short-lived reorganisation.”

In order to avoid a policy failure, HCSA has made a series of recommendations including:

  • A full financial analysis of each STP footprint to establish the actual level of funding required to meet their goals. Ring-fenced STP funding
  • Footprint-by-footprint stress testing and the requirement of a clear evidence base for local proposals in order to force STPs to address the lack of detail in their plans
  • The establishment of Clinical Oversight Groups composed of clinical staff with robust powers to assess the impact of plans on patient care
  • A realistic timetable that recognises the fact a “transformation on this scale requires, and merits, several years to develop processes and undertake consultation”
  • Greater transparency around the work of STPs and how they are accountable