STPs: A new way to force through NHS cuts

The NHS has been hitting the headlines again in recent days as the government’s plans to decimate our services have received some attention. Health campaigners have been trying to organise against these proposals since they were first introduced at the beginning of the year. Its no accident that its been hard to get coverage – the proposals have been crafted in a way that make local scrutiny of what is likely to be swingeing cuts extremely difficult.

We republish this article from Health Campaigns Together – see for more information of what campaigners across the country are planning.

Since January England’s NHS has been carved up into 44 “footprint” areas, in which commissioners and providers are supposed to collaborate together.

That might appear to be good news, if the complex, costly and divisive competitive market system entrenched by Andrew Lansley’s Health & Social Care Act was being swept away, and a new, re-integrated NHS was empowered to work together again to improve services.

But that’s very much NOT the case: instead the main task of the “footprint” areas is to balance the books of each “local health economy” – taking drastic steps where necessary to wipe out an estimated £3.7 billion of underlying deficits built up by trusts last year. Each area has to draw up a 5-year Sustainability & Transformation Plan (STP), to be vetted by NHS England.

And while they do so, all of the legislation compelling local CCGs to open up services to “any qualified provider” or put them out to tender remains in full force. The private sector is still snapping up contracts.

The rule book has been torn up, legislation somehow avoided, and a coup launched led by NHS England chief executive Simon Stevens.

Stevens is the man who urged Tony Blair’s government to experiment with private sector providers for the NHS, and then spent nine years at the top of US health insurance giant UnitedHealth. So we have reasons to mistrust what is taking shape now.

Sweeping powers

The 44 leaders appointed by Stevens to lead planning in the “footprint” areas are to be given powers to override the checks and balances within the legislation, with minimal consultation.

They’re encouraged to overcome the “veto powers” of individual organisations to stand in the way of controversial changes. And they must force through unpopular decisions on the disposition of hospital services.

The detail is yet to be revealed and the plans of the 44 will not be made public until the autumn, but we know enough to predict that:

  • ·        Many A&E departments and hospitals will be closed or significantly downsized
  • ·         Hospital capacity will be significantly reduced in return for promises of investment in         “care in the community”
  • ·         The priority in the NHS will be the capping of budgets and eradication of deficits
  • ·         This will be achieved by restricting access to healthcare, cutting capacity and
    reducing staff
  • ·         Due process enforcing rational decision making will be set aside to ensure decisions
    are made in support of these plans, without any delay.

For the latest info, and to share what’s happening in YOUR area, check out the Health Campaigns Together STP Watch pages at www.healthcampaignstogether. com/STPplans.php, or email us at

National Conference –
Challenging the STPs

Birmingham, Saturday September 17

11-4pm Carrs Lane Conference Centre

(opposite Moor St Station)

Book online now

Since January NHS England has driven through a massive new reorganisation of the NHS. They have carved the country into 44 “footprints” in which commissioners, NHS Trusts and local authorities are required to collaborate on 5-year plans to generate massive savings.

On one level this could be seen as a step forward from the chaos and fragmentation of the competitive market imposed by the 2012 Health & Social Care Act: however the ever-tightening vice of the unprecedented spending squeeze on the NHS makes it unlikely that the collaboration will result in any enhancement of services.

Each Footprint has to submit a “Sustainability and Transformation Plan” (STP) to NHS England by the autumn and be ready to implement the changes quickly to balance the books: only plans which satisfy NHS England will ensure access to £1.8 billion of “transformation funding”.

NHS England boss Simon Stevens has made clear he sees the reorganisation as a way to create “combined authorities” which pool their powers – making it possible to override any local “veto” that might prevent controversial cuts or closure of popular local hospitals and services. The little local influence and accountably there is in the NHS will be eliminated. The new system leaves no room for serious consultation before 5-year plans are drawn up behind closed doors and imposed on local communities.

The new system also lacks any legal basis. Stevens’ plan simply sidelines the Clinical Commissioning Groups – but leaves them still obliged by the Health & Social Care Act to continue to carve up services into bite sized, fragmented chunks. Services are still being opened up to “any qualified provider” or put out to competitive tender. The whole fragmented, wasteful costly market system remains intact.

So what are the plans that local health bosses are hatching up in secret? How do these new structures work? Who is in charge, and how can campaigners and local communities make them accountable and prevent them cutting and centralising services and worsening access problems for patients needing care? With jobs and services at stake, how can unions collaborate with local campaigners and political parties to maximise the impact of their efforts?

Come and discuss at a conference that seeks to develop policy as a basis to strengthen and unite our efforts.

Open to all. LUNCH provided.
Registration £7.50/£5 in advance, £10/£7 on the door.

Share your thoughts and local plans:
email us at




Be the first to comment

Leave a Reply

Your email address will not be published.