Dr Chris Mimnagh: Why drawing up STPs in secret could prove to be a masterstroke

Secrecy around STPs has infuriated patients and the public, but it may have allowed managers and clinicians to deliver a more honest appraisal of the future of local healthcare, says Dr Chris Mimnagh. But the NHS must now engage with local people as never before.

Zeitgeist gemeinschaft?

I think I've already spoken about my passion for the German ability to create words that capture moments which English struggles to encapsulate in a sentence.

Recent international and national political events have left some of our patient populations feeling either ebullient or depressed. Although politics is way above my pay grade, sustainability and transformation plans (STPs) are firmly in my targets.

NHS chief executive Simon Stevens is undoubtedly one of the cleverest men on the planet. So ask yourselves why has he apparently engineered deliberately the biggest blunder since Andrew Lansley's implementation of the Health and Social Care Act?

Of course I'm referring to the fact that STPs have been drawn up under a cloak of apparent secrecy.

Did he not realise the furore that would be caused when these plans became public, having been drawn up in isolation with no members of public present? Did he think that the excuse of tight deadlines would wash with the media?

If you think Simon Stevens has been naive, then I think you're misjudging him.

What he has skillfully done is create an opportunity for a discussion at community level between clinicians and managers about the ideal, dream scenario for your healthcare area. In splendid isolation clinicians and managers have been able to draw up plans, which they feel are most likely to result in a sustainable NHS.

There probably isn't an area in England that would have reached its current conclusions if they had been drafted in the presence of the public.

Now, perhaps unsurprisingly, the details have been leaked and we find ourselves faced with patients demanding to know why the local accident and emergency department is scheduled for closure, or why the local stroke centre is being amalgamated.

I happen to believe that Simon Stevens appreciated that this was likely to happen, In fact I think he expected it.

This approach means that right now we have no choice but to engage as never before with our local populations – not just a casual patient engagement exercise but real meaningful engagement with the spirit of the community.

Or as the Germans would put it, zeitgeist gemeinschaft.

  • Dr Chris Mimnagh is a GP in Liverpool and co-director of clinical strategy at the NHS partnership organisation Liverpool Health Partners

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