Crucial information on huge five year plan for future of Gloucestershire’s NHS is being withheld, campaigners claim

Stroud Against the Cuts (SATC) says key figures and projections in the county’s five-year Sustainability and Transformation Plan (STP) are being kept secret.

The STP, published in November, sets out a blueprint of strategies to reduce costs, change services and improve care – while tackling the county’s huge £226 million deficit.

Campaigners claim these plan’s budgets are “riven with holes” and provide no information on projected changes to staffing levels, number of beds, asset sell-offs, or deficits of the NHS Trusts.

They fear that behind closed doors the full plans hold details on “further cuts and sell-offs” to the county’s “much loved and vital hospitals”.

SATC have accused Gloucestershire Clinical Commissioning Group (CCG) of withholding this information, and are demanding greater transparency on what the changes will mean for services in the county.

In addition, the campaigners are calling on elected representative at Shire Hall to vote to reject the plans if full details are not revealed and greater assurances secured.

In a letter to all county councillors, James Beecher, chair of SATC, and co-ordinator Caroline Molloy, editor of OurNHS openDemocracy, said they had “deep concerns” about the STPs.

“We note with deep concern that the plan contains no guarantee that current levels of hospital provision will be protected,” they wrote.

“We further note with deep concern that assumptions are made throughout the plan that may well undermine the provision of hospital and other NHS care in Gloucestershire in future.

“It claims that Gloucestershire can become above average in simply everything, without explaining why or how this is possible, let alone how it will save £72.2m, on top of another £70m of ‘provider efficiencies’.

“Perhaps most worryingly of all, the plan is riven with holes in the capital budget.

“It makes clear that the savings are ‘capital dependent’ but where the approximately £150m investment is to come from, is left largely unspecified.

“Given the lack of guarantees about estates and workforce, the suspicion must be that these holes will be filled with further cuts and sell offs of our much loved and vital hospitals, and greater reliance on private patients.

“We are certain that Gloucestershire CCG will hold more detailed information on the financial, operational, estates and workforce plans, more in line with that information provided in other areas, which they have not disclosed.”

The campaigners called on Gloucestershire county councillors to “reject” the STP until all the figures and their impact are “fully disclosed”.

Councillors - who have not seen the full plans – will be asked to sign off on segments of them in February.

The letter garnered differing levels of support from different political parties on Conservative-led Gloucestershire County Council (GCC).

Dorcas Binns, Tory county councillor for Nailsworth and Cabinet Member for Older People on GCC, welcomed the chance to “address concerns” about the STP, but insisted it was “not about cuts”.

“It is a pretty good deal for Gloucestershire,” she said. “It sets out how our NHS can work smarter in future –more GP appointments, easier access to NHS services and improved A&E care.

“It’s not about cuts- the government has promised Gloucestershire’s NHS an extra £73m over the next five years –a massive boost.

“There are big changes elsewhere in the country – but because Gloucestershire’s STP covers just Gloucestershire, I think our NHS has been able to listen much more carefully to what local people have to say – which is good news all round.”

Sarah Lunnon, county councillor for Stroud Central and Shire Hall’s only Green, said the STP had huge holes in its budget and how it would achieve savings.

“The safety of our NHS and social care is about to undergo a huge experiment,” she said.

“Based on no given studies the STP outlines a move to remote IT access and self-management. This is worrying, it's a gamble with limited available evidence and the history of IT in the NHS is one of wasted billions.

“Secondly the plan doesn't appear to be funded - there is a gap of roughly £100 million.

“It doesn't take a genius to look at the partner organisations signed up to this plan, look at the missing millions and realise the one source of capital they have is land and buildings.

“It might not be the plan to flog of our hospitals and health centres but if there is another one that comes up with £100 million I look forward to seeing it.”

Lesley Williams (Stonehouse), speaking on behalf of the Labour Group, said her party would continue to press for a “full briefing” to be given to all county councillors on what is in the STP.

She also claimed there was a political agenda to why information was being withheld – saying that the details of possible cuts were being kept secret until after next year’s county council elections.

“Gloucestershire Labour Councillors have a proud record of defending and advocating for an NHS that adheres to the principles of the founders of the NHS that resources should be allocated on the basis of need not for profit,” she said.

“A number of us lobbied hard to get the STP placed into the public domain which it now has.

“However, what is most telling is what is not in the Plan. It seems that the controversial topics such as detail on budget ‘savings’ and assets will not be discussed or put into the public domain until after next year’s May county council election.

“This will come as no surprise as the Conservative controlled county council do not want to expose their planned cuts in the public health budget or how they propose to handle the ongoing crisis we have in the county for Adult and Social Care.

“We are pressing for a full briefing to be given to all county councillors on what is in the STP and to question the Health Bodies on the omissions as mentioned above.

“Labour county and district members on the County Health and Overview Scrutiny Committee which all health bodies have a duty to attend, continue to raise and question decisions being made that effect patient care.”

The Gloucestershire CCG responded to the letter from Stroud Against the Cuts, but declined to address any of the issues raised.

Dr Andy Seymour, clinical chair of NHS Gloucestershire CCG, said: “Working together as ‘One Gloucestershire’, the STP aims to build stronger, healthier communities and transform the quality of care and support we provide to local people.

“The future looks challenging - a growing population with more complex needs and increased demand for services.

"It means we need to be ambitious and innovative in how we organise services and use the resources available.

“STP priorities include greater emphasis on prevention of illness and self-care with extra money to support it, spending more money on GP services and mental health, providing more joined up care and support in people’s homes and in the community, pursuing excellence (across the board) in hospital services and developing a sustainable local NHS workforce.

“High quality care and safety will remain our priorities throughout.”

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• Background on Gloucestershire’s Sustainability and Transformation Plan (STP)

STPs aim to sustain and transform all NHS services for each of the 44 regions in England and implement the vision of the five-year forward view with its emphasis on self-care, prevention and collaborative working in large multi-disciplinary organisations.

The NHS is working with the county council and a range of community partners to implement the Gloucestershire STP.

It sets out a number of changes designed to tackle the predicted deficit in the county’s health and social care services.

Every year of the next four years, Gloucestershire’s NHS services will be forced to find £57 million in savings between them.

This will see CCG face an uphill battle to tackle a projected budget deficit of £226 million.

NHS bosses say they are a way to achieve a healthier population which is less dependent on health and social care services, and to tackle the challenges of a growing and ageing population and with increasingly complex needs.

The STP sets out priorities including placing greater emphasis on prevention of illness and self-care, with investment to support this, and providing more joined up care and support in people’s homes and in the community.

It also plans to explore options to bring together some district general hospital services into ‘centres of excellence’ to ensure ‘safety and quality’.

It also prioritises developing a ‘best use of medicines’ programme and priority fund the drugs and treatments that have the greatest health benefit for the population, developing a sustainable workforce and making the most of new technologies.

But critics warn that among the many shakeups, changes and ‘savings’, the plans are essentially a way of reducing staff and funds from the NHS.

While Gloucestershire’s STP, which are available online, do set out financial figures, plans to shakeup services and save on costs, SATC say there are key parts missing.

Their particular focus is on how these changes will affect staffing levels, any changes to the amount of hospital beds and whether or not the CCG will have no choice but to sell off assets.

People in Gloucestershire are invited to provide their feedback by February 24, 2017.

Complete the survey online at www.gloucestershireSTP.net