Third STP published, asks for at least £80m for digital

A third council has broken ranks with NHS England’s preferred sustainability and transformation plan process and put its full STP online.

The London Borough of Sutton has published the South West London STP on its website, saying that “we are concerned the NHS centrally has not allowed the publication of our STP and that this is raising worries about its content.”

The STP footprint contains several acute hospitals that have been the subject of closure or reconfiguration plans over the years. The latest plan proposes cutting the number of acute sites from five to four, although a reduction to just three has also been modelled.

Despite the local focus on hospital reconfiguration, the STP follows those published earlier this week for Birmingham and Solihull and North Central London in identifying technology as a “critical enabler” of its recommendations.

Specifically, it says there will need to be investment in “whole systems intelligence” to support commissioning and information sharing to support a move towards “delivering the right care in the best place”. It also identifies a need for “digitally enabled self-care”, for the “channel shift” from face to face to digital services, and investment in education and training for users.

The STP says it will need £80 million of capital to support the implementation of the parts of its local digital roadmap that cover these requirements. The implication is that the hospitals that remain on its patch will need further IT investment as “capital relating to individual provider roadmaps, including point of care solutions, is not included.”

NHS England published the ‘Five Year Forward View’ plan to close a projected deficit of £30 billion by 2020-21 almost exactly two years ago, in October 2014. Since then, the government has pledged to find an additional £8 billion of funding for the NHS by the end of the Parliament.

This leaves the NHS to find £22 billion of efficiency savings, of which £15 billion is expected to come from local healthcare economies. In response, 44 areas have been formed to draw up STPs to say how these saving will be found within their footprints.

Final versions of the STP plans had to be sent to NHS England, NHS Improvement, the Care Quality Commission and other arms length bodies by last Friday. NHS England wants to review the plans before they are published, and run them by its communications teams.

However, councils appear to be using their democratic mandate as a basis to publish. The South West London STP outlines the sheer scale of the task ahead of it, noting that if nothing is done the footprint area will be facing a deficit of £828 million by 2020-21.

This, it says, “makes it very challenging to deliver the high quality care that the public rightly expects”. However, it warns that its plans will require “very significant amounts of capital” that is likely to be in short supply.

Although last year’s Treasury settlement for the NHS included a ‘sustainability and transformation fund’, almost all of the £2.5 billion that should have been disbursed last year has been swallowed up by an acute sector deficit that reached £2.4 billion last year.

In addition, NHS England and NHS Improvement officials told the health select committee last week that a quarter of the NHS’ capital budget has been diverted to revenue this year.

Even if it secures the funding it wants, the South West London STP says that getting into financial balance will require a 44% reduction in bed days and a 20% reduction in ‘unnecessary’ outpatient appointments.