25. Hertfordshire and West Essex

What does the STP mean for your area?

Almost 30 hospital beds will be lost when two wards of St Albans City Hospital are shut

The Princess Alexandra needs £150 million to create a “functioning hospital” for the next 10 years.

The West Hertfordshire needs £178 million for critical backlog maintenance, loan repayments and to address urgent capacity and compliance needs.

The STP document is not clear on where the money for this will be found.

Herts Valleys Clinical Commissioning Group is in a precarious financial position, heading for a £15m deficit in 2016-17 unless it makes “controversial decisions” to cut patient services.

Herts Valley CCG cut funding to measures that prevented delayed discharge from hospital. Worth £8.5 million the cut measures are key to the implementation of the STP.


What are the proposed aims of the STP

  • Elimination of a projected 2020/21 deficit of £550 million;
  • Improve health and well-being and reduce demand for services;
  • Integration of primary and community services;
  • Reduce demand for hospitals and move care out of hospital;
  • Reduce variation in hospital care.
  • Overall, the aim of the STP is to reduce the use of the hospital sector and increase the use of community and primary care sector.


Further information

The STP lacks detail on how the deficit is going to be eliminated, yet care and services maintained.


An “agreement in principle” has been reached for West Hertfordshire Hospitals to “formally” be part of the Royal Free London Foundation Trust hospital group by April 2018.

Greater partnership working between East and North Hertfordshire and The Princess Alexandra hospital, with the trusts looking to create “pan-provider” pathways across vascular surgery, paediatric urology, specialist cancer surgery and others, as well as integrating back office support services.

In the STP there is also the potential redevelopment of Hemel Hempstead Hospital into a community hub/local hospital facility in the final year of the STP period.

Community care

Collaborative commissioning between the three CCGs in the footprint, with the aim for each to save 20% by 2021.

The creation of an accountable care partnership in west Essex including some parts of an MCP and PACS models of care.


The STP notes that there will be changes to the workforce with £109 million of savings identified from “other provider productivity/staff changes”. The plan does not specify if staffing numbers will be cut. It says it will “develop short term actions and long term strategies” to help solve agency, recruitment and retention issues as well as matching staffing plans with new care models.