Consultation on full STPs impossible, NHS officials warn council leaders

Public consultation on an entire sustainability and transformation plan (STP) is impossible, NHS bosses have told London councils.

Leaders of the North East London (NEL) STP said there was 'no suggestion' the plan would be subject to consultation because it has not been proposed by a specific statutory organisation.

The comments appear to contradict an earlier statement by health secretary Jeremy Hunt, who told MPs in November he could 'absolutely' assure that there would be full consultation on STPs.

Speaking to the Inner North East London joint health overview and scrutiny committee on Tuesday, NEL STP's director of provider collaboration Julie Lowe said: 'There is no suggestion that the STP as a totality would be something that would be subject to consultation because it has not been brought by an organisation. So it would be a change within STP that would be considered for public consultation.'

STP consultation

The NEL official suggested that most reforms proposed in the area's STP were unlikely to require consultation anyway. Ms Lowe said that only significant changes to services such as closures would be considered for consultation. 'At the moment we are not consulting on anything because there are no proposals to do anything that would be meeting that threshold by quite a wide margin,' she added.

NHS England has advised the 44 STP areas that formal consultation is required only where a substantial variation to service configuration, such as a hospital closure, is proposed.

But councillors on the scrutiny committee, which includes representatives from four boroughs and the City of London, raised concerns that the cumulative effect of the STP, which is seeking to close a financial deficit of £578m across the area over five years, could be considered significant.

GPonline has reported that NHS leaders behind the STP area planning for a 50% reduction in GP numbers in the area over the next five years.

Hackney councillor Ben Hayward told STP leaders: 'The problem here is that you are dealing with such a huge amount and, you say it's not talking about closing hospitals. Well, the Homerton [hospital] budget per year is about £270,000. You are talking about closing Homerton for two years... So when added together I think there may be a strong counter argument to say that it, in its cumulative effect would amount to a substantial variation on any local area.'

NHS funding

Waltham Forest councillor Richard Sweden added that councils should 'be on the lookout' for changes to services being 'artificially split up, so that the smaller parts don't represent any significant variation'.

NEL STP programme director Nichola Gardner added: 'We are very committed to making sure that where there is change that requires significant changes to service we are committed to taking that through the formal consultation processes.'

But the STP's director of communication and engagement admitted that 'the whole notion of STP or what it's about, hasn't been communicated in an ideal way. And people haven't felt engaged.'

Before the meeting local GPs and health campaigners called on councillors to follow the example of other local authorities and reject the STP. Dr Anna Livingstone said the NHS was in 'complete crisis', and the STP solution was forcing through 'cuts plans'. She called on councillors to 'say no to the STP'.

Terry Day from Waltham Forest Save Our NHS said the STP's effective reduction in the number of hospital beds per head amounted to 'planned neglect'.

Photo: iStock

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