STP is coming - Kill or cure for our NHS?

According to Labour Sustainability and Transformation Plans are based on: "... a model from America, where it is used to deliver private, insurance-based healthcare."(Margaret Greenwood MP)

The Prime Minister says: "The STPs are about local people determining the shape of health services in a local area, to deliver the best service for local people. Obviously, every area will be looking very closely at the plans that are being brought forward. It is important that we see, in those STPs, health services increasingly working with local authorities to ensure that they are providing the right, holistic level of care for people in their area."

Which version is correct? We may find out on Wednesday (Dec 14th), when Wiltshire's plan is due to be released. STPs are part of the managed decline of the NHS as budgets continue to fail to keep up with demand. It'll be interesting to see if they have a major impact or are just another NHS transformation scheme.

An outline of the plan has already been published and can be seen in the agenda for the Wiltshire Health and Wellbeing Board. The key phrase is:

"If we do nothing to change how we deliver our services, the gap between available income and cost of services will rise to c£300m per year by 2020/21"

What this means is government cuts are creating a £300million deficit in the local NHS. There are two answers to that - you either increase funding or you cut services. The government won't do the former so we have to deal with the latter. Local NHS bosses won't call them cuts but will talk about efficiency savings, though genuine efficiency savings will be impossible to find to the required extent.

Here for example are some of their putative action points with translation into English:

9. Mapping our Estate across the footprint and planning the future estate need based on future clinical models. (Asset-stripping).

10. Three acute Trusts working collaboratively on those services identified as potentially 'unsustainable'. (Looking for economies of scale irrespective of effect on patients)

12. Improved sign-posting to support services through partner agencies such as the fire service. (Cost-shunting)

Here's a further update following publication of the full plan.