Cornwall’s STP: “merely rearranges the diminishing deckchairs of our NHS”

Caroline Lucas joins Andrew George on the frontline

Health campaigner, former West Cornwall MP and member of the Common’s Health Select Committee, Andrew George has warned that Cornwall’s NHS Sustainability and Transformation Plan (STP) is “fundamentally budget-driven” and that the Government’s STPs “merely rearranges the diminishing deckchairs of the NHS. They are not charting a course to safety”.

Mr George said, “Though, on the face of it, STPs seem worthy and laudable, they divert attention away from the actions necessary to protect the NHS. Cornwall’s STP is a largely irrelevant diversion into the challenges NHS managers face; matters of functional implementation, most of which are best left to those responsible for delivering the service. However, it masks the covert political intensions of the Government; a Government which knows full well that it is both starving the NHS of the cash it needs and is recklessly forging ahead with ‘reforms’ which risk undermining patient safety.

The STPs are fundamentally budget-driven and are about forcing local communities to decide how to cut their own services. STPs run the high risk of diverting vital time and effort away from the very matters our communities should be most concerned about. Instead these projects would be better directed at identifying what resources a local NHS and social care service needs to be both safe and sustainable.”

Mr George helped to persuade his Liberal Democrat colleagues to adopt a policy of “if necessary, increasing income tax…to protect the NHS”. He believes that health communities “should be asked to design robust services based on the best standards, not to meet eye-watering budgetary pressures”.

Mr George supports the statement published yesterday by his Liberal Democrat colleagues on Cornwall Council. 

He added, “most of the six themes of Cornwall’s STP are unarguable objectives which hardly require public consultation. No one disagrees that it is better to ‘prevent ill-health’, better ‘integrate services’, ‘improve productivity’, have ‘better care’ etc. Much of the STP is padded out with customary NHS management babble which simply repeats themes which were accepted as desirable objectives more than a decade ago. They just need action rather than flannel.

The one exception to this is the theme of rearranging urgent and emergency care. That element needs to be taken out for more thorough scrutiny and a consultation of its own. Some of the proposals have not been thought through and would leave Cornwall with a dangerously threadbare service.

The kind of Sustainable NHS Plan which Cornwall needs most is one designed by those of us who are committed to retaining a world renowned public health service. One that: 1) requires investment in primary and community care, 2) gives mental health equality of status with physical health, 3) enhances rather than cuts the number and role of District Nurses, 4) supports rather than undermines the essential role of professional clinicians (doctors and nurses) throughout the service, 5) guarantees safe registered nurse staffing levels in secondary hospital care and enough beds to better manage infection control and the inevitable peaks in demand and 6) removes rather than increases the perpetual risk of the NHS putting profit before patient care.

Above all we need to be honest about how much this will cost. Of course the job of driving out waste and securing efficiencies is a perpetual task which ought to have been an indisputable key duty of managers since the NHS was first created, not just to wait for STPs to come along. But it is now vitally important that we tell the Government that the STPs miss the target. The NHS is unsustainable, nor can it be safely transformed without additional investment.”

Mr George will be holding a public meeting on the STP at The Exchange Gallery, Penzance at 7.30pm on 18th Jan with a range of invited speakers on a panel.

Background info on Cornwall and the Isles of Scilly’s STP: Outline Business Case

The six system themes of our Target Operating Model

Radical upgrade in population health and prevention

An enhanced focus on local population health to improve outcomes and manage demand on the rest of the system.

Integrated care in the community

An integrated, place based approach to care in the community will be at the heart of our system.

Transforming urgent and emergency care

Enhanced, consistent services responding effectively to crises, preventing issues escalating and enabling quicker recovery.

Redesigning pathways of care

Improved pathways across the system, helping to ensure that the future delivery of services is viable and sustainable.

Improving productivity and efficiency of system enablers

Aligned and streamlined functions across people, processes, technology and estates to support the whole system.

Using system levers for better care

Agile, joined-up leadership and commissioning arrangements with a focus on the needs of the whole population.