Doubts have been raised about the credibility of the blueprints for NHS reform with which ministers expect to stave off an impending financial crisis.
A BMA review of England’s 44 STPs (sustainability and transformation plans) has found that many of their claims to save £26bn from NHS and council social care budgets appear unrealistic.
Many such savings plans also depend on securing large sums of upfront capital cash – to modernise or construct new health facilities – a demand the NHS admits it cannot meet.
Most STPs claim costs will be cut by moving NHS services out of hospitals, the review finds, despite research suggesting that shifting care into the community does not make significant savings, particularly within the five years that STPs cover.
‘Evidence to support the impact of large-scale reconfigurations of hospital services on finance is almost entirely lacking,’ the King’s Fund paper, The Reconfiguration of Services: What is the Evidence, concluded in 2014.
And despite the widespread expectation of savings by providing more care in the community, many plans fail to make clear how over-stretched GPs will be funded to take on the extra work.
Several plans even propose cutting the number of community and acute hospital beds, such as those in Staffordshire and Stoke-on-Trent, Derbyshire and Nottinghamshire.
Most list ‘public health and prevention’ as a priority but are unclear how this squares with the Government’s cuts to the budgets of councils that have run many such services since 2013.
Several councils have already publicly opposed the plans drawn up for their areas, the review found.
Full story in The BMA, 27 January 2017