22. Norfolk & Waveney
What does the STP mean for your area?
An assessment of the STP by Norwich News found that there are cuts in every area of the local NHS and social care, apart from mental health. Much of the money, £144 million, will be saved by NHS trusts and councils carrying out their own cuts.
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?
- Cutting of a projected 2020/21 deficit of £415 million to £50 million;
- to reduce non-elective admissions, A&E attendances and enhance hospital discharge processes;
- Increased integration in care and the creation of 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.
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.
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 £5.3 million in 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 and £8.4 million of savings in 2020/21.
Community care and social care
These services will get an investment of £18.8 million in 2020/21 but is being cut by £45.5 million in that year alone.
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 in 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.