North London publishes draft STP with ‘serious reservations’ over process

The sustainability and transformation plan (STP) for the North Central London (NCL) was published because of a need for greater public involvement in the process, a council leader said.

The draft STP, which covers Camden, Haringey, Islington, Barnet and Enfield, reveals promises of service transformation, but also financial challenges and plans to consolidate services.

NCL is the second area to publish its STP after Birmingham and Solihull yesterday.

Cllr Sarah Hayward, leader of Camden Council, said: “There is a national crisis in both the health and social care systems – both need to change and we recognise that they could be more efficient. That said, I have serious reservations about the Sustainability and Transformation Plan process so far.

“There has been no political oversight, and minimal public and patient engagement. At present, there is a lack of appropriate focus on adult social care. That lack of public, patient and political involvement is why I am publishing this document on our website. It is vital that there is full transparency in Camden as this work progresses.”

Speaking in front of the Health Select Committee recently, Chris Hopson, the CEO of NHS Providers, warned that many STPs are developing “vastly over-ambitious” plans which could fail because of a lack of capital or political support.

The NCL STP strategic framework has four aspects: prevention, service transformation, productivity and enablers.

As part of the service transformation, the STP notes that it has identified clinical areas where it is considering introducing “consolidation” of services, which it says it recognises could be “challenging to implement and controversial with the public”. It said it is already developing proposals to bring together mental health inpatient services.

Other commitments for service transformation include:

  • Developing a shared dataset for child and adolescent mental health services
  • Developing physical and virtual ‘care closer to home integrated networks’ to provide multi-disciplinary care for specific patients
  • Providing pre-bookable and scheduled GP appointments from 8am to 8pm, seven days a week
  • Establishing a female psychiatric intensive care unit
  • Ensuring urgent and emergency care meets national and London quality standards, and provides consistent care across different services
  • Exploring “collaboration and consolidation” between local authorities in areas such as hospital discharge and mental healthcare

The productivity plans include:

  • 5% efficiency savings a year on the STP’s £133m community service costs
  • 1% efficiency savings a year on continuing care, currently at £90m
  • 5% efficiency savings a year on prescribing costs, currently at £205m
  • Establishing a shared recruitment and bank function for staff
  • Consolidating IT services
  • Reducing variation in procurement

The prevention plans include encouraging every member of the public sector workforce to become “a champion for prevention”, and ensuring that working and living environments promote good health.

The enablers to be addressed include better use of digital technology, developing an estates strategy, and a workforce strategy where staff are “part of  the wider NCL workforce,       not just part of a single organisation”.

This plan is being implemented in the context of intense financial challenges, with the STP footprint facing an £876m deficit by 2021. To combat this, the STP said it would invest £64m in prevention and care closer to home, to achieve £124m savings. Other areas for savings included £6m from improving mental health outreach and liaison, £55m from optimising the elective pathway, and £98m from increasing system productivity.

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Maurice Neville   30/10/2016 at 19:33

This utter shambles, with some STPs published and other still kept secret by those too timid to defy the idiots in NHS England, is a fitting outcome of Lansley's arrogance, Hunt's incompetence and Osborne's butchery of the NHS budget.

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