22. Norfolk & Waveney
What concerns have been raised about your STP?
Health planners are trying to reduce NHS deficits and think about ways to re-organise care. However getting the large deficit under control could prevent facilities being developed that can cope with the health and care social needs of local people.
Overall cuts in every area of the NHS and social care system apart from mental health.
The plan is for one in five patients who currently go to hospital being cared for in community instead.
Lack of investment
Growing debts are projected to reach £415 million by 2020/21. The STP aims to make £300 million in savings, but will need £150 million in investment to achieve this. Overall, GP surgeries, social care and community care will have to make savings of £56 million, while getting an investment of £33 million by 2020/21. Hospitals must save £26 million, while being given just £5.3 million.
There was criticism of the secrecy in development of the STP, its lack of detail and the amount of cuts that will have to be made to services. Clive Lewis, Norwich South Labour MP, said: “These people must be living in some kind of parallel universe to the rest of us where black is in fact white and gravity is a force that pulls objects up to the sky. The reality is you can’t continually do more with less. Cutting funding for services does not improve them."
What are the proposed aims of the STP?
- To cut a projected 2020/21 deficit of £415 million to £50 million;
- to reduce non-elective admissions, A&E attendances and enhance hospital discharge processes;
- to increase integration in care and create localised teams to deal with physical, mental and social care;
- to target lifestyle risk factors (e.g. alcohol, obesity) to improve the population's health and secondary prevention preventing unnecessary escalation to higher acuity care settings;
- in general, the aim of the STP is to reduce use of the acute sector and move care closer to home.
Like other areas the STP aims to transfer services out of hospital and into the community. The concern is that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.
The STP does not contain detailed plans on how the proposed aims will be achieved with the current funding as well as eliminating the deficit.
Overall the plan aims to save £300 million, but will need £150 million in investment.
The aim is that one in five patients who currently go to hospital will be cared for in community instead by community health services and GP surgeries.
Hospital budgets must save £26 million while being given just £5.3 million by 2020/21. They hope to save £4 million by reducing A&E attendances by 20%.
Mental health is the only area of the health and care system getting more money overall with a £14 million investment but will have to make £8.4 million of savings by 2020/21.
Community care and social care
Social/community care will get an investment of £18.8 million, but social care alone needs to make cuts of £45.5 million.
Overall, GP surgeries, social care and community care will have to make savings of £56 million, the largest amount of any area, while getting an investment of £33 million by 2020/21.
The prevention service which encourages people to live more healthy lifestyles will be given £4.2 million but needs to save £12.7 million.
Criticisms of the STP to date have focused on the secrecy under which it was developed, the lack of detail in the document and the extent to which services will have to be cut.
The secrecy surrounding the STP has been criticised; prior to the October submission the STP had only been seen by a small group of health chiefs. It has been kept from MPs, councillors, NHS staff, GPs, unions and some hospital board members.
Speaking out about the STP, North Norfolk MP and former health minister Norman Lamb said he welcomed any extra money for mental health but said the whole STP was “unachievable” with the cash being made available and that “the detail is just not there.”
Although involved with the drawing up of the STP, Alex Stewart, chief executive of Healthwatch Norfolk, said their board did not endorse the STP document because they felt it did not contain enough detail about how patient care would be transformed.
“What concerns me still is that there is a lot of rhetoric but not a lot of action,” he said.