NHS reforms

Minister vows for ‘more emphasis’ on sluggish STPs, but demands better buy-in

Health minister Philip Dunne has suggested that the government will be putting “more emphasis” on ensuring the sustainability and transformation plans (STPs) that are not as well developed as others can move along at a clearer pace – but stressed that a lot of this will come down to local buy-in from relevant organisations.

Speaking at the second day of Health+Care, Dunne validated the criticism that there is a lack of “uniform clarity or coherence” within STPs that have already been written, and assured the audience of delegates that the government will be putting further emphasis on bolstering the plans that are lagging behind.

“But some of that comes down to the leadership and the buy-in from the component organisations. We need to do more to ensure there is clear leadership in each STP area, and to support the leaders that are in place with the work they’re doing,” argued the minister.

“And I can assure them that there is very significant political support to the work they are doing – please recognise that, and if you are finding difficulty within your areas in getting buy-in from relevant NHS organisations, then please let NHS Improvement, NHS England or us in the department know.

“The STP process presents an opportunity both to deal with some of the challenging configuration issues, which made it difficult to deliver good standards of care in some parts of the country, and have been problematic for many years in some areas.

“And secondly, to focus systems on funding transformation, whether that’s through capital injections – including the initial phase which was announced in the Spring Budget to support STPs, and we expect to make our first allocation announcement before the summer recess of that funding – or whether it’s through more imaginative and locally-generated schemes through either the sale of surplus land or more efficient use of estates.”

Asked by the session’s mediator, health commentator Roy Lilley, to expand further on the need to get political buy-in into the STP process – a particularly relevant issue as of late, with several anti-STP campaigns beginning to emerge across localities – Dunne explained that it’s important to emphasise proposals for reconfigurations come from the clinicians themselves.

“There are, from time to time, some difficult decisions to be made, and what I would say is that it’s absolutely understandable that politicians will argue against change if it’s going to reduce the immediacy of service in their area,” he added.

“But I’d also say many politicians recognise that if clinicians are saying to them ‘our patients will have better outcomes if we do this, and this is the evidence that will prove it’, then they’re not blind to the quality argument. They can be persuaded that this is something that needs to go through.”

As well as confirming the continued support of the new government towards the Five Year Forward View (FYFV), Dunne clarified that Whitehall also backs the accountable care systems (ACSs), nine of which were announced recently by NHS England boss Simon Stevens.

“The combined potential of the areas identified so far is some £450m of funding over the next four years, which will be delivered by matching accountability for improving the health and wellbeing of the populations they cover,” he said.

The minister was not able to confirm when the NHS and the public at large will be able to find out more about the extra £8bn top-up included in the Conservative manifesto, but he did promise that the money would be “a real -terms increase per capita for each year of this Parliament”.

As expected, Dunne was also questioned on the government’s decision earlier this week to reject a Labour move to scrap the public sector pay rise cap, which has been met with fierce criticism and protest. He clarified that the decision to boost MPs’ pay a few years ago – in sharp contrast to the frozen salaries of the rest of the public sector – was made by the Independent Parliamentary Standards Authority, and reminded delegates that the next doctors’ and nurses’ dedicated pay review bodies will be reporting on their recommendations next year.

Lilley then argued that “as a long-time watcher of the political dances”, he does not think Jeremy Hunt would have recently suggested he would speak to the chancellor about the possibility of reviewing the cap unless “he thought he had a fair chance at making a change” – but Dunne said it was “way beyond” his job’s credibility to comment on these discussions.