Grassroots GPs 'ignored' as NHS regions draw up STP reform plans

Sustainability and transformation plans that will reshape NHS services to fit local areas and map out additional investment in general practice are being designed without input from grassroots GPs, LMCs have warned.

Sustainability and transformation plans (STPs) for 44 areas, or ‘footprints’, across England are due to be submitted by the end of next month (June), but ‘little or no’ GP provider input has been incorporated, according to LMCs in some areas.

STPs are intended to plan for sustainable general practice, and the GP Forward View, published last month, said the process would lead to extra local investment for general practice.

But GP leaders say that much of the input from general practice in local STP planning has come from GPs involved in CCGs, rather than those whose sole concern is working on the frontline.

GP providers

Birmingham LMC executive secretary Dr Robert Morley said: ‘Typically and unsurprisingly the only GP input has been via CCGs, with a complete misunderstanding and/or neglect of the fact that CCGs are commissioning and performance management bodies and in no way have any role representing GPs as providers.’

Dr Morley said his LMC had made it clear to the local STP leadership that GP and LMC engagement was essential if their plans were to succeed, and a meeting has now been arranged.

A number of the centrally appointed STP footprint leads are GPs working for CCGs, but none are solely provider GPs.

Avon LMC chairman, Dr Simon Bradley, said the footprint in his area covers three CCG areas, but it had no non-CCG GP representation on the group producing the STP.

‘With more than a little pressure from us there has been some movement but there is still no representation,’ he said.

CCG role

‘We now have a named GP representative for each CCG area, and even though there is an assumption that they will be invited to join the STP, there has been no invitation so far.

‘They have to make a submission by the end of next month, which means it is likely to go ahead without any formal GP provider input.’

Londonwide LMCs medical director, Dr Tony Grewal, said there had been ‘little or no’ involvement from GPs in the London area.

‘NHS England typically make an announcement with great trumpets and fanfare and then want they want something two days later,’ he said.

‘Most of our GPs are too busy with their day jobs.’

A spokesperson for NHS England said: ‘Footprint areas have determined their own governance arrangements as locally appropriate. While it is not possible to ensure representation from every provider and commissioner on their patch, we have encouraged them to ensure a wide range of voices is heard including those of front line GPs. Half of the footprint areas are being led by GP-controlled CCGs.’

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