Under pressure from the public and Stop STP campaigners, Councils are reviewing and discussing the footprint STP for their area in Health and Wellbeing Boards, Scrutiny Committees, Cabinets and full Council meetings.
Here are summaries of what 19 Councils have decided to do about the Secret Theft Plan for their area. Please email if you have info about more Councils.
Barnet Council reports:
The NHS in the north central London area – which represents Camden, Haringey, Islington, Barnet and Enfield – has submitted a draft Sustainability and Transformation Plan (STP) to NHS England.
This has been developed by a host of NHS organisations with the support of officials from the area’s local authorities to propose changes to the way services are delivered, to make them more effective and efficient. Leader of Barnet Council, Councillor Richard Cornelius, said:
“This proposal from the NHS would effectively organise health on a five borough basis. Local politicians are concerned that the process of developing this proposal has not yet involved them or taken into account the views of Barnet people. ”
At a time when social care provision needs to be aligned with NHS priorities, there needs to be a consensus with councils as it directly affects local services and the health and well-being of our residents. Over the coming weeks we will be seeking residents views before presenting the findings to Policy and Resources Committee.”
You can read the North Central London STP online.
The Barnsley Overview and Scrutiny Committee meeting on 6th Dec 2016, to consider the South Yorkshire and Bassetlaw Sustainability and Transformation Plan, gave the Clinical Commissioning Group some grief – 11 committee members spoke & 10 were councillors. At least 5 were confronting the CCG and 3 more asked challenging questions but less assertively.
The Barnsley Health &Wellbeing Board on the same day only had 3 councillors out of the 4 on the board – one was in the chair & only one asked challenging questions. It went through without much discussion & no vote.
BUT the meeting was packed with council officers, Clinical Commissioning Group, Hospital trust, community trust & the regional NHSE rep. All but the last rep are also involved in the South Yorkshire & Bassetlaw STP Board that actually wrote the STP so it was NOT the council approving it – or not – it was a quango of public bodies agreeing that the document they’d written themselves – with a few friends -was good!
The Health &Wellbeing Boards are a QUANGO set up by the 2012 Health & Social Care Act and have no powers – they create the Joint Strategic Needs Assessment & strategy to meet the need, that’s all. The approval of the STP is NOT one of their statutory functions. It was a meaningless exercise. As was the CCG Board vote to approve the STP on 8 December. They wrote it too!
The Health &Wellbeing Boards are NOT a council meeting – but councils are tasked with convening, facilitating & chairing the H&WBs.
Barnsley Health &Wellbeing Boards only has 4 councillors + 3 officers out of 15 members so the councillors couldn’t outvote the others even if they wanted to.
Councillor Paulette Hamilton, cabinet member for health and social care at Birmingham City Council, said:
“I believe this is the right direction of travel and it is vital that we have a fully integrated health and social care system. I would like to reiterate on behalf of Birmingham City Council our strongest possible commitment to a collaborative and place-based approach. The council has consistently made clear that the funding crisis facing the social care system can only be addressed by a more imaginative whole system redesign and the STP I hope will be the starting point, and I urge people to give their views as part of our public and partner engagement.”
But on 5 Dec the Birmingham Mail said that the Birmingham Scrutiny Committee Report on the STP warns that it could cause the collapse of the city’s social care system.
“The STP presents a significant risk that, through fewer hospital admissions and shorter hospital stays, it will move care and costs from the NHS to the social care system without making any provision for increased home-care or social care resources, which could actually increase the gap and thus worsen the immediate crisis in social care.”
The Report, which was discussed by the Council on 6th Dec 2016, calls for the STP to prioritise investment in social care, recognise the importance of council-funded public health services and deal with the lack of co-ordination between the Black Country and Birmingham STPs which could leave people living in west and north Birmingham without services.
One of the 5 WY Councils whose leaders signed a letter to NHS England that they:
“understand the need for change and support the aspiration to address the current financial, quality and outcomes gaps. We are, however, unable to endorse the content of the West Yorkshire and Harrogate-wide STP as, while the high level outcomes of the plan have been discussed with various officers of our councils, the submission has not yet been to any formal Council forums or endorsed in any of our planning processes.”
However this letter is not a rejection of the STP, it is a statement that the Council Leaders want to consider the STP and respond to it as soon as possible; and that they think:
“The STP process marks an important opportunity for residents, local government and the NHS to shape future services. We believe there is a need for more discussion and involvement as plans develop, and we look forward to future clarity on the role of local government and communities in this.”
Bristol Meeting In Common South Gloucestershire and North Somerset Health Scrutiny Committees, People Scrutiny Commission Joint Meeting Thursday, 1st December, 2016 2.00 pm
About 50 councillors turned up (there’ll be a list of attendees noted at some point). It was an informal meeting, the agenda was about ‘receiving’ the STP.
Bristol Protect Our NHS handed out their STP analysis to every attendee + plus the Health Campaigns Together News sheet on STPs
There were about 15 contributions – from across the political full spectrum, from all three councils.
Not one word in favour. All critical. Main complaints: Secrecy, lack of transparency, lack of engagement with political leaders + cllrs didn’t know what was happening, let alone patients and the public, where was LA governance in plan, little about social care impact, no concrete plans for consultation, no financial details, inaccessible (jargon, vague, obtuse) plan.
The point was made by some speakers that just because the councillors had ‘received’ the plan, it wasn’t about offering any support, so at this stage Bristol has not formally come out against the STP – that will have to go through other channels
Calderdale – see Bradford
Devon County Council on 8 Dec 2016 passed 2 NHS motions – 1 about the proposed cuts as set out in the STP, the 2nd, about the Success Regime.
The first motion, about the proposed NHS cuts as set out in the STP,
‘calls on local MPs to lobby government ministers to urgently and significantly increase the level of funding to the NHS in order to protect our precious health services for current and future generations’.
The second motion, on the NHS Succcess Regime,
“asks the Secretary of State for Health and NHS England to put the process on hold, until issues relating to the ‘independence’ of the Success Regime are investigated and for fair funding to be considered. County Council further calls on Government and NHS England to firstly address the issue of fair funding for our area and to ensure the general election promise of an extra£8billion of funding for the NHS is taken into account when assessing the claimed deficit for Devon NHS services. Until funding issues are addressed it is not possible to decide whether or not there is a local NHS budget deficit to be addressed. Unnecessary cuts to local NHS budgets must be avoided!Devon MP’s be asked to support this approach to protecting Devon NHS services”
The motions put pressure on 8 Tory MPs to defend their constituents’ services by using their position as nearly the whole of the government’s majority to force an increase in NHS funding – but they doesn’t amount to the Council’s rejection of the Devon STP
Ealing Council is the only one, apart from Hammersmith and Fulham (see below) that we have heard that the Council Leader has refused to sign the STP. This is interesting because some other Councils have denied that they were ever sent the STP to read or sign before the STP programme office sent it off to NHS England for the 21st October deadline. Asking your Council Leader about this could clear quite a lot of muddy water surrounding Councils’ role and involvement in the STPs.
Cllr Julian Bell, Leader of Ealing Council, said:
“The NHS tried to bounce us into signing the STP. They tried to get us to agree to the STP on the basis of a two-page summary and they told us we didn’t need to see the full document. We insisted, but it didn’t arrive until they day before we were meant to sign it. And once we finally saw what was in it, we understood why. There was no way on earth I was going to sign up to those plans.”
Enfield Council Leader, Councillor Doug Taylor, said:
“The Sustainability and Transformation Plan for North Central London has far reaching implications for health and social care services for everyone in Enfield.
“I am concerned that, to date, there has been very little engagement with the public about this incredibly important process. It is therefore important that residents in Enfield have the opportunity to view the draft plan at this stage.
“It is also very important that further recognition is given to the importance of adult social care services on health and wellbeing.
“Enfield Council believes that the best way to move the process forward is through an honest and open conversation with local people about what the proposals will mean for them. I urge everyone to make their views known.”
Hammersmith & Fulham
See Ealing, above
See Bradford, plus: at the 9 Nov meeting Kirklees Council, the agenda item item 14 Holding the Executive to Account (on video) included Cllr Kendrick’s report on STP. There were then some questions and statements across parties, with the Council Leader saying he would not sign off the West Yorkshire & Harrogate STP without a Council debate and Cllr Kendrick agreeing with this. So we shall see when there is to be a Council debate on the West Yorkshire & Harrogate STP and what the Council decides.
Leeds – see Bradford
Liverpool City Council
Liverpool Echo reports that Mayor Anderson spoke out against the STP at a meeting of Liverpool Health and Wellbeing board.
At the meeting he said:
“I have chaired this Health and Wellbeing Board for the last three years, yet this is the first time we have been asked, without appropriate consultation, to comment on a major strategic plan by Government which will directly affect many vulnerable residents within our city and the city region.”
“I want to make it very clear that the proposals within the STP are rejected by the Council and this Board, because it fails to address the key issues facing our residents and their health in the years to come. The STP is damaging to our Health Service and undermines any faith we could have in the Government’s ability to invest in a future for the NHS.”
Mayor Anderson added:
“As a city, we all support the principles of joined up working between the Council, health services and others, including residents themselves, for better integrated services, particularly in adult social care.
“However, there has been no, I repeat no, consultation or engagement with the city.”
But the Health & Wellbeing Board will have discussed the STP at various points throughout the past year, like all the other Health & Wellbeing Boards. So why didn’t they do the shouting earlier?
The Liverpool Echo says Liverpool’s health and wellbeing board is purely consultative and does not have the power to reject the STP, which remains on the agenda.
Not really sure what it means beyond the rhetoric.
Wirral Council did a similar thing – see below
Oxford City Council
Motion carried by Oxford City Council 5 December 2016 as it appears on the City Council website
This Council notes that the government is dividing the NHS in England into 44 areas or ‘footprints’, each of which has a ‘Sustainability and Transformation Plan’ (STP).
Government requires these STPs to collectively deliver cuts of at least £2.5bn nationally this year, and £22bn within the next five years, to wipe out the NHS’ so- called ‘financial deficit’ by implementing ‘new models of care’.
The former head of NHS commissioning, Julia Simon, has denounced the STP process as ‘shameful’, ‘mad’, ‘ridiculous’ and the plans as full of lies .
Locally, the Council notes that the Chief Exec of Oxfordshire Clinical Commissioning Group (Oxon CCG) has said that without changes to local NHS provision there will be a cumulative funding gap of about £200 million by 2020-21 and that the STP will need to change service provision to eliminate it . Council further notes that local NHS employers face particular challenges from the high cost of housing locally, the mitigation of which may require investment.
Council considers that the Buckinghamshire Oxfordshire Berkshire West (BOB) STP
(a) Does not contain adequate or indeed any information on which a decision can be made about the future of NHS provision in what the STP refers to as ‘the BOB geography.’ It presents aspirations couched in meaningless jargon and suggests, without any evidence, that the unspecified STP Plan will result in the transformation of a projected deficit of £479m to a surplus of £11m by the end of 20/21.
(b)Establishes any basis for a consultation to be carried out with health professionals and members of the public. Indeed the timeline in the STP suggests no consultation is envisaged since ‘agreement on the plan’ is to be reached with NHS England in November/December, before any consultation is even planned.
Council believes is possible that the STP for the area which includes Oxfordshire (BOB- Bucks, Oxon and Berks) contains measures which could seriously impact on the health and welfare of the local population, and that the insistence by NHS England upon restricting early publication is leading to harmful speculation.
Council notes that wider consultation on the STP has not yet started, and calls for the immediate publication of the STP, in full, with proper consultation to take place with patients, interested public, private and community bodies, and staff. Council notes the frustration recently expressed by senior CCG officials about NHS England’s negative attitude to timely publication and consultation of the STP, and believes that, especially in difficult times for the NHS, early engagement of all stakeholders is vital, and exercises in secrecy prevent constructive engagement from public bodies and local communities, and foster an atmosphere of mistrust.
Council endorses the view recently expressed by the Oxfordshire Health Inequality Commission that significant investment in interventions to reduce health inequalities and prevent poor health and illness are very important, and believes that such services are at particular risk when pressures on the NHS are scheduled to rise faster than funding. It therefore asks the CCG to prioritise investments which will reduce health inequality and support services towards groups suffering from health inequalities.
Council rejects the suggestion that there is a safe way to reduce the current level of NHS provision by £200 million (the gap identified by the CCG) by 2020-21 and agrees to:
· Ask the Oxon CCG to fully disclose to the public what changes are being considered with NHS England lifting its bar on publication
· (add) Provide what support it can to the STP consultation
· Ask the Oxon CCG to start a full consultation as soon as possible on all aspects of the proposed changes
· Encourage the public to make their views on the services reductions and changes known by promoting the consultation on the Council’s website, social media and through wider media communications
· Invite the County & District Councils to work together with the City to oppose any changes which will harm patients
· Write to the relevant Government Ministers to express Oxford’s grave concern about a plan which is being foisted upon NHS professionals and the public in this city without adequate or indeed any information about the change in the level of services which must be intended.
· Write to the City’s MPs asking for their support
North Yorks County Council
N. Yorks County Council Health Scrutiny Committee 18th Nov 2016, chaired by Cllr. Jim Clark ( Harrogate ward), was very unhappy with North Yorkshire being carved up into three footprint areas – each attaching part of rural North Yorkshire to urban areas – Middlesborough, West Yorkshire and Hull. AND NHS England left Craven off their map!!
They have written to NHS England and Jeremy Hunt asking for the planned footprints to have their boundaries redrawn to give North Yorkshire control of its own footprint. The funding shortfall that the three STPs have to deal with by cutting costs by April 2021 was estimated to be £1,750 million. The NYCC Health Scrutiny Committee members highlighted that the only way that this could be realistically achieved would be through significant cuts to services.
The week before, concerns were raised about the future of Darlington Memorial Hospital at the meeting of the County Council. Early proposals considered by the STP may mean that Accident and Emergency and consultant-led maternity and paediatric services there are downgraded.
Cllr Clark stated
“Any downgrading of services at Darlington Memorial Hospital would have a real impact upon people in North Yorkshire as they would be expected to travel to Middlesbrough to get the help they need. If you live in some parts of the Dales, this could mean a 60 mile journey over difficult terrain. What is being considered for Darlington Memorial Hospital also raises concerns that other, local services may be downgraded elsewhere in the county.”
Shropshire Star says Shropshire Council has a lack of confidence in the plan. The report doesn’t say if the Council was asked to sign it off before it went to NHS England.
It’s not just Shropshire Council that doesn’t have confidence in the STP. Neither does NHS England. On 7 Dec they sent Shropshire Clinical Commissioning Group a formal letter saying that their STP has not been approved and instructing them to submit a revised STP by December 23. The key point was that NHSE have no confidence in the financial plan –
their big concern is that Shropshire CCG does not have a credible financial recovery plan and this will undermine the operational plans.
Someone in Sutton emailed STP Agony Aunt that the Sutton Council leader is rumoured to have written to Sue Richards, Keep Our NHS Public steering group member, that Sutton Council has rejected the STP. But there is no public statement about this. STP Agony Aunt advised her to write to the Council Leader asking her if she has written to NHS England about the Council’s view of the STP and if so, what she said.
Telford and Wrekin Council
Shropshire Star reports that Telford & Wrekin Council says it has a lack of confidence in the financial projections and the reliability of the rationale for future cost reductions.
It also says significantly more resources should be put into prevention and the reconfiguration of community and primary care services, rather than these being concentrated on the reconfiguration of hospital services.
Wakefield – see Bradford
Wirral Health & Wellbeing Board http://www.stopthestps.org.uk/mad-as-hell/459326751