ABANDON STPs DEMANDS BMA CONFERENCE – Motion moved by Anna Athow carried overwhelmingly

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ANNA ATHOW (second from left) with supporters. She stood as a WRP candidate – to defend the NHS – in the recent general election
ANNA ATHOW (second from left) with supporters. She stood as a WRP candidate – to defend the NHS – in the recent general election

A MOTION moved on behalf of the London Regional Council by Anna Athow demanding the Tory NHS Sustainability and Transformation Plans (STPs) are ‘abandoned’ was passed with an overwhelming majority at the BMA’s Annual Representative Meeting (ARM) in Bournemouth on Monday.

Doctors debated the future of Sustainability and Transformation Plans (STPs) at the BMA’s annual conference in Bournemouth this week. Millions of patients are being adversely affected by the Tories’ Sustainability Transformation Plans (STPs) while at the same time new health managers receive ‘eye watering’ six figure salaries.

Agenda Committee motion 42 stated: ‘That this meeting condemns the woeful manner in which STPs have been progressed, turning them into vehicles to try to legitimise further cuts to vital NHS services, and proposes STPs are abandoned.’

The BMA has released a new analysis of figures which has found:

• £8.5m salary bill for new health managers delivering STPs.

• £1.1m spent on private consultancy firms and agency staff.

• Millions of patients could be affected by hospital and A&E closures and bed losses.

• Vast differences in STP process across country.

New figures, obtained by the BMA through Freedom of Information requests reveal that more than 150 jobs, including operations managers, communications executives, administrators and financial analysts, with combined annual salaries of at least £8.5 million, have been created to deliver Sustainability and Transformation plans.

The actual numbers are likely to be much higher, with only around half of the 44 STP footprints responding to the request and others unable to give detail of remuneration for some staff. Some of the STP areas advertised jobs for agency staff or private consultants, with at least £1.1 million being spent on external firms.

Just five areas accounted for more than £5.5 million of the spending:

• Cambridgeshire and Peterborough created 28 job roles at a cost of £893,000 annually

• Milton Keynes, Bedfordshire and Luton created 12 jobs at a cost of £920,000

• North Central London created 19 job roles at a cost of £974,000

• Leicestershire and Rutland created 22 job roles at a cost of £673,000

• North East London created 37 job roles at a cost of £2.3 million.

The investigation has also revealed a major disparity in the processes being carried out across the country. In some areas, like Lincolnshire, health leaders said they were using the resources already at their disposal to move the STP process forward – but in others, like North East London which has employed 37 staff, whole ‘project management teams’ have been created.

These figures come alongside a new report on STPs published today by the BMA, analysing all 44 STP plans.

The report finds that:

• 17.6 million patients could be affected by hospitals closing or merging (including both community and acute care);

• 22.9 million patients could be affected by A&Es closing or downgrading;

• 14.7 million patients could be affected by acute bed closures;

• 6.6 million patients could be affected by community bed closures.

The report also found that:

• There has been a poor engagement with clinicians, patients and the public considering the scale of patients affected;

• Rushed timelines and the scale of the financial challenge mean that plans are being implemented without the appropriate evidence;

• The upfront funding needed for to deliver plans has not been provided;

• The scale of the cuts that need to be delivered by STPs will have a worrying effect on patients.

Previous BMA research has found that the 44 STPs will have to make at least £26 billion in cuts to keep inside the public funding constraints set by the Government and that the plans require at least £9.5 billion of capital funding but NHS leaders are unlikely to have anything like the capital required to deliver the projects. The BMA has serious concerns with how STPs have been put together and the way that the overall process has been run.

Commenting, BMA council chair, Dr Mark Porter, said: ‘Millions of patients will be affected by hospital and bed closures under these so-called “transformation plans”, which are a cover for delivering £26bn in cuts to health and social care.

‘It makes no sense to spend this kind of money on staffing and structure when we already know there is a huge shortfall in capital funding needed to actually put the plans in place. Any money spent here runs the risk of being completely wasted. With the NHS at breaking point, doctors and patients will be horrified to see millions being spent on another layer of bureaucracy to deliver these controversial plans.

‘The NHS needs more GPs, junior doctors and consultants – there is nothing sustainable or transformational about creating another costly team of managers while staff on the frontline struggle and patients suffer as a result. From its very beginning this process was carried out largely behind closed doors, by rushed health and social care leaders trying to develop impossible plans without the necessary funding.

‘Some of these STPs seem to be ballooning into new health and social care structures with no mention in law and no proper governance – making a mockery of the top-down reorganisation forced on the NHS in 2012. This analysis casts serious doubt on these plans. Doctors and patients deserve a properly funded, transparent health service with patient care not cost cutting at its core.’

• Patients are increasingly forced to ‘crowdfund’ their own wheelchairs as NHS provision is not enough, doctors warn. Hundreds of patients have turned to online fundraising, the BMA annual meeting heard. Doctors have urged the NHS to improve its wheelchair provision as it emerged a growing number of patients are using crowdfunding to pay for their own wheelchairs.

A junior doctor working in south London told medicals at the British Medical Association (BMA)’s annual representative meeting in Bournemouth ‘hundreds’ of patients are turning to online fundraising due to delays and being offered heavy wheelchairs that are unsuitable for their needs.

Dr Hannah Barham-Brown, who has Ehlers-Danlos syndrome, which means her joints dislocate easily, said she used crowdfunding to buy a lightweight chair that allows her to move independently and reduces the risk of damage through manoeuvring a heavy frame.

‘The standard NHS chair can weigh up to around 20kg and it’s very poorly designed – it’s not remotely ergonomic,’ she said. In terms of public transport I wouldn’t be able to go anywhere in an NHS chair unless there was someone with me helping me. You need to be pushed.’

Delays, cuts to services and a ‘postcode lottery’ in wheelchair availability across the country is fuelling the rise in people making public appeals to buy them – with charities also stepping in to provide wheelchairs when the NHS is unable to.

There are around one and a half million wheelchair users in the UK, two thirds of whom are regular users. Dr Barham-Brown used crowdfunding to pay for her own 12kg wheelchair, which cost around £2,000. She said she was now able to get around more easily at work and play sports, including basketball, in her chair.