NHS Finance

14.12.16

STP capital requests ‘exceed what is available’

NHS England does not have enough capital to fulfil funding requests for the controversial STPs, new board papers show.

The 44 STP footprints, intended to help local health systems provide more integrated care, are now in the process of being published. However, they have been criticised for focusing on balancing budgets rather than delivering reforms.

Chris Hopson, CEO of NHS Providers, one of many senior figures in the NHS to express reservations about the process, has said that they risk “blowing up” because of a lack of funds.

A report, published ahead of tomorrow’s NHS England board meeting, says: “Capital is very tight over the next few years; STPs’ requests exceed what is available.”

NHS finances are under unprecedented pressure, with the year-to-date deficit reaching £648m in the last quarter.

Last week Jim Mackey, chief executive of NHS Improvement, told the House of Lords NHS Sustainability Committee that he had yet to see an STP with a convincing business case for more investment.

All STPs will have to be published by mid-December and contracts for the 2017-18 and 2018-19 round will then be agreed by 23 December in order to make it possible to implement the plans in the New Year.

According to the report, NHS England and NHS Improvement will review all STP capital requests.

Funding will be available for “strategic schemes that are essential for unlocking local improvements and efficiencies”.

STPs will need to prove that the plans offer benefits for patients and a return on investment. NHS England also said it was more likely to favour plans that were “shovel ready”.

The report added that “wide-ranging participation” from councils, the public, charities and other health and care organisations is “at the heart of STPs”.

It says that once STPs are published, regions will “need to do more” to engage clinicians, with engagement taking place locally, across STP boundaries, and on a national level with royal colleges and specialty associations.

The BMA has accused STPs of being introduced “under the radar” without proper consultation with frontline providers.

A number of STP footprints have themselves been critical of the process. Two Shropshire councils recently refused to endorse their region’s STP, and North Central London organisations have admitted to “serious reservations” about their plan.

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