Dear Gloucestershire County Councillors,
We are extremely concerned by the disparity between the level of information, including financial information, contained in the Gloucestershire NHS plan (known as the ‘Sustainability and Transformation Plan’ or STP) as published by Gloucestershire Clinical Commissioning Group (CCG), including the appendices, and the details contained in STP submissions in other “footprints” using the same financial template.
Information that has not been published in Gloucestershire, though it has been published in other areas, includes:
• the estates strategy for the county’s hospitals
• projected county-wide bed figures
• projected county-side staffing/workforce figures
• figures for the future projected deficits of each of the four main NHS Trusts providing healthcare to Gloucestershire, and the impact on them of these plans
• a proper Risk Register of planned productivity improvements
We note with deep concern that the plan contains no guarantee that current levels of hospital provision will be protected.
We further note with deep concern that assumptions are made throughout the plan that may well undermine still further, the provision of hospital and other NHS care in Gloucestershire in future. Notably, the plan makes many assertions about the potential for arrangements for self-care, active communities, and the benefits of digital investment, without citing one single piece of evidence to justify any of those assertions. It claims that Gloucestershire can become above average (compared to similar counties) 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. In both the financial segment of the main plan, and the appendices (notably the digital appendix) we are told that this investment is to come partially from small central government pots, but also from ‘3rd party developer capital’ (private finance initiative?) and from ‘unknown’ sources. 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.
Our concerns about this process are shared by NHS insiders up and down the country – for example Julia Simon, former head of NHS England Commissioning, recently denounced the process as ‘shameful’ and ‘mad’. (1)
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. For you to even consider allowing your paid officers to approve a plan whose details you have not been allowed to see, while contracts are due to be signed by 23 December, would be a dereliction of duty. We call on you to reject the plan, pending its full disclosure followed by a full, statutory 3 month consultation with the public and all interested parties, including NHS staff and their unions
We will be working with others to ensure that county councillors attention to the future of our local health services is highlighted in the forthcoming county council elections, and to this end have copied the local press in to this email. We thank you for your urgent attention to this matter.
Chair, Stroud Against the Cuts
Co-ordinator, Stroud Against the Cuts, and Editor, OurNHS openDemocracy
(1) 'Shameful' pace of STP rollout risks financial meltdown, warns former NHS commissioning chief, GP Online, 28th September 2016