GPs demand halt to STP process amid fears of 'severe' NHS cuts

Dozens of GPs in an east London borough have signed a statement calling for the sustainability and transformation plan (STP) process to be halted.

Dr Jackie Applebee: warning over impact of STPs
Dr Jackie Applebee: warning over impact of STPs

More than 30 GPs - nearly one in six of the entire workforce in Tower Hamlets - as well as a number of nurses, managers and other staff from practices in the borough, warned that the requirement on NHS organisations across England to find £22bn in savings was not possible without ‘severe’ cuts to services.

The statement, published to coincide with the end-of-December deadline for NHS contracts and operational plans for the next two years to be signed off, called for STPs to be stopped and for NHS services to be adequately funded.

‘We are not against change that is clinically evidenced but we cannot sanction this financially driven exercise,' the statement said.

Read more: what is an STP?

Primary care minister David Mowat told the RCGP annual conference last autumn that STPs would be blocked if they are opposed by a consensus of GPs, while NHS England, which is leading the STP process, has said that GPs would be able to engage with the proposals.

But last month RCGP vice chair Professor Kamila Hawthorne said the college’s ambassadors, who are supposed to be representing GPs in the local STP processes, had in some cases been blocked from seeing the plans.

STPs will have a major impact on general practice, with several forecasting significant reductions in GP numbers in their area in coming years.

Tower Hamlets CCG chair and North East London (NEL) STP clinical director, GP Sir Sam Everington, told the House of Lords last year that local health bosses had projected a 50% fall in GP numbers over the next five years across the eight-borough STP footprint.

GP workforce

A local transformation plan covering three of the NEL boroughs, including Tower Hamlets, aims to recruit and train more than 100 physician associates in GP practices to help offset a forecast 30% fall in GP numbers. Practices in the area could be consolidated to serve populations of 10,000 or more.

In December NEL STP bosses told local councils there could be no consultation on the whole of the STP because it was not being proposed by a single NHS organisation.

Tower Hamlets LMC chair Dr Jackie Applebee, a signatory to the anti-STP statement, previously told GPonline that while the ambition for greater integration of services around patients was in line with the kind of care GPs wanted to provide, the STP was ‘completely unrealistic’ given the financial state of the local health system.

‘It raises expectations,' she said. ‘And somebody needs to call this what it is. It is the Emperor's New Clothes. I don't think people should collude with this. They should shout from the rooftops that this is a slashing of our NHS, forcing us into cheaper models and ultimately making it more attractive to the private sector.’

Tower Hamlets GPs' statement in full:

'The NHS is unprecedented financial crisis. The proportion of GDP spent on the NHS is going down year on year and is one of the lowest in Europe. Most acute hospital trusts are in deficit and the proportion of the NHS allocation spent on general practice is at an all time low at a time when work is being transferred from secondary to primary care. There is also a workforce crisis in general practice. Young doctors are not choosing it as a career and older doctors are leaving. The situation is such that a recent GPC survey revealed that 84% of GPs feel that their workload is either excessive or unmanageable. This is not safe for patients.

'On this backdrop the sustainability and transformation plans mandated by NHS England, which have to be signed off on 23 December, will demand £22bn of "savings" across the NHS in England.

'We believe that it is not possible to "save" this amount of money without severe cuts in service. The NHS is struggling to function as it is and it is a testament to all the staff who work in it that it still provides such an excellent service.

'We are not against change that is clinically evidenced but we cannot sanction this financially driven exercise.

'We demand that the STPs are stopped and the percentage of GDP spent on the NHS be restored to a value to adequately resource it and provide patients with the care they deserve.'

Dr Anna Livingstone, Limehouse Practice

Dr Jackie Applebee, Tredegar Practice

Dr Ruth Vickers, formerly of Limehouse Practice

Dr Mike Fitchett, Island Health

Mostafa Farook, Practice Manager, The Barkantine Practice

Dr  Sella Shanmugadasan, Harley Grove Medical Centre

Dr Andrea Green GP Island Health

Maggie Falshaw, Practice Manager, Jubilee Street

Dr Archana Spahn, Ruston Street

Dr Dilesh Patel, Ruston Street

Dr Naimish Amin Ruston Street

Carline King (Nurse) Ruston Street

Laura Ross (PM) Ruston Street

Amy Bramley (HCA) Ruston Street

Layla Abdul-Motlib (Reception) Ruston Street

Nazia Gazi (Reception) Ruston Street

Salma Begum (Reception) Ruston Street

Dr Ingrid Franklin Bromley by Bow Health Centre

Dr Emily Woolridge, GP Partner, Bethnal Green Health Centre

Dr Ben Hart, Crisp Street, Health Centre

Dr Shaheena Shakoor, GP Locum

Dr Raquel Gracia, Salaried GP East One Health & Cable Street Surgery

Dr Soraya Boomla, GP St Stephens Health Centre

Dr Alison Smailes, GP Crisp Street Health Centre

Dr Sangeeta Rana, Merchant Street

Dr Nirupam Talukder, Grove Road Surgery

Dr Naureen Bhatti, Limehouse Surgery

Dr Rosanna Pollen, Bethnal Green Health Centre

Dr Kirti Shah, Grove Road Surgery

Dr Dimple Varma, Brayford Square

Dr Tai Okun, Harford Health Centre

Dr Jennie Read, Limehouse Health Centre

Dr Win-Leung Siu, XX place

Dr Kobir Ahmed, Spitalfields practice

Dr Saida Desai, Spitalfields practice

Dr Mohammed Sanaullah, Spitalfields practice

Dr Alim Uddin, Spitalfields practice

Dr Anwara Ali, Spitalfields practice

Emma Stanford Practice Manager, Spitalfields practice

Dr Naomi  Beer, Jubilee Street

Dr Shamira Bhikha - Tower Hamlets GP

Dr Haroon Rashid, Albion Health Centre

Dr Mike Callaghan, St Stephens Health Centre

Dr Selvaseelan Selvarajah

Dr Munmun Rashid, Wapping Group Practice

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