” … “The GP profession (alongside nurses, paramedics and so many others in the NHS) is struggling to recruit and retain its workforce – perhaps this has been the reason why we have not been asked to come to the table. We are imploding from workload and burnout. Shifting work into the community is already happening without an increased workforce and there’s no plan to increase dwindling GP numbers.
These plans are setting alarm bells ringing. Involving frontline staff or the public in any meaningful way is likely to pose delays for their implementation. And as NHS England states in its own guidance, due to financial challenges “we do not have the luxury of waiting until perfect plans are in place”. Certainly it could be argued that STP boards are trying to make the best out of the must-do mantras, rigid financial control and timescales stipulated by NHS England.
The greatest danger of STPs is that they become the focus not of improvement or innovation but of cost-cutting
Can there be any room for transformation at a time when many of the STP organisations are experiencing significant financial deficits? Can we moderate demand, promote self-care, roll out seven-day access, improve cancer and other health outcomes, reduce hospital and emergency nursing home occupancy and balance the books? The greatest danger of STPs is that they become the focus not of improvement or innovation but of cost-cutting: moving bottle-necks of demand from one setting to another and leading to poorer health.
Ultimately the level of NHS deficit will dictate how achievable these STPs become. In the end it seems that NHS England is asking local organisations to deliver a sugar-coated pill that may look ambitious and futuristic, but will nevertheless still be bitter to swallow.