This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

GPs 'excluded' from consultations over secret plans for general practice

GP leaders have said they are being 'excluded' from discussions over vital new plans currently being drawn up by CCGs, hospital trusts and local authorities that could reshape general practice in their area.

The ‘Sustainability and Transformation Plans (STPs)’ – which will map out the future health strategy of 44 regions across England - are in many cases being keeping them secret until they are finalised and approved by NHS England later in the autumn.

Many LMC leaders told Pulse they have not been shown the plans, despite the fact they were submitted to NHS England in June, and even those that have seen them said there has been no consultation.

The lack of transparency comes despite the brief from NHS bosses setting out that these STPs have to detail plans for the ‘sustainability and quality’ of general practice, including ‘workforce and workload issues’.

Birmingham LMC medical secretary Dr Robert Morley said that in his area the LMC has ‘indirectly had sight of’ proposals to do with ‘delivery at scale’ general practice but that ‘there has been no consultation on their plans’.

He said: ‘The full plan has not been shared with the LMC, let alone have we been consulted.

‘All this work is at an advanced stage of development and has been going on for months before it has been shared with general practice provider representatives.’

Londonwide LMCs said that in some cases GPs were being excluded from the process altogether.

Chief executive Dr Michelle Drage said: ‘Excluding LMCs from the table does not mean any practical issues they would raise will go away, instead they will only become known at the implementation stage, where addressing them is complex and costly.

‘STP footprints in London should be involving LMCs, the only bodies which statutorily represent all GPs in their areas, and we call upon them to do so.’

LMC representatives in Northumberland, Wolverhampton and Yorkshire told Pulse they had not even seen the plans.

Meanwhile, Dr John Ashcroft, an executive officer of Derby and Derbyshire LMC, said that the STP draft was ‘forwarded to the LMC, and then another email was sent round asking that they are not shared further’.

The RCGP has appointed 29 GPs as ‘regional ambassadors’ to ‘help ensure that the 108 proposals outlined in NHS England’s GP Forward View are implemented.

And a spokesperson for the West Yorkshire STP region, from the West Yorkshire Partnership NHS Foundation Trust, said they were ‘keen to fully link in with GPs via the RCGP’s newly appointed STP ambassadors’.

An NHS England spokesperson said it was up to each region how they wished to share their draft plans.

NHS England chief executive Simon Stevens has said STP regions have identified the need for investment in new and existing GP premises, with now being the ‘ideal time’ to invest.

But in Salford, where STPs are at an earlier stage because it forms part of the Manchester devolution deal, the plan is to save £35m from ‘GP collaborative working’.

Local papers in London have also reported on the leaked STP from northwest London planning to cut 500 hospital beds.

Pulse asked every one of the 44 regions to share the plans, but every single one refused, while campaign group 38 Degrees has also launched a petition for the STPs to be made public.

What are STPs?

At the end of last year, NHS England tasked regional teams, CCGs, trusts and local authorities with forming regional footprints, and then write plans for how the NHS Five Year Forward View would be delivered within them.

By January, 44 footprints were formed, and by 30 June each had submitted its first draft Sustainability and Transformation Plan (STP) to NHS England.

As previously reported by Pulse, each plan has to adress ‘sustainability and quality’ of general practice, including both ’workforce and workload issues’.

At the time, NHS England chief executive Simon Stevens said: ’This guidance sets out the next steps to make the vision set out in the Five Year Forward View a reality.

'A new approach to how local NHS leaders plan to meet health needs across whole areas will sit alongside the new Sustainability and Transformation Fund established as part of our £560bn funding plan for the NHS.'


Readers' comments (35)

  • "Colloborative working" = the new buzz phrase/rod to beat us with

    Unsuitable or offensive? Report this comment

  • RCGP are collaborating in the destruction of the proffession.TRAITORS ALL!

    Unsuitable or offensive? Report this comment

  • Not so secret in Manchester
    At meeting with CCG Chief Exec was told in no uncertain terms that new Voluntary Contract is not 'voluntary'. LES and QOF Funding will be at risk if practices continue with nGMS!! Thanks GPC for your support

    Unsuitable or offensive? Report this comment

  • Industrial action?

    Unsuitable or offensive? Report this comment

  • The BMA should act. Let's go the dentist way and forget all this interference in our work. High standards are not met with the funding or staffing. Blaming GPs for doing 90% of the work. We must stop accepting this unfair blame and be aware it is the managers and government causing this. Let uis not participate in their plans. Brexit for us!

    Unsuitable or offensive? Report this comment

  • STP's are an oxymoron as you can't have transformation and sustainability in the same sentence. Something has to give in order for there to be change. The drivers of the plans have too many conflicted interests about preservation of their own organisations. The reason GP's have been omitted is because there is the expectation they will just absorb all the unfunded work in the spirit of collaboration after it is a done deal! The ultimate goal is to make general practice a fully salaried scheme as part of larger accountable care organisations. The role of the Dr Findlay family doctor will go to be replaced by an American style pile them high all you can eat faceless financially driven heartless business.
    Why we try and copy the US is beyond me other than to open the door through the TTIP to denationalising the NHS, oh that's right Jeremy supports that ideology as he wrote it in Direct Democracy!!

    Unsuitable or offensive? Report this comment

  • There is no patient representation. also as discussed before the RCGP is not the legitimate representatives of general practice. the BMA is through the LMC's.

    There is no point in speaking to the RCGP to discuss your STP plans. If you truly want general practice to be on board and to shape then this needs to happen through the LMC.

    thank you

    - anonymous salaried!

    Unsuitable or offensive? Report this comment

  • RCGP champions are self selected and are not representative of GPs.
    I agree we need to #NHSExit
    Let the patients pay us - I'd rather they were my customer than NHSE/politicians.

    Unsuitable or offensive? Report this comment

  • Folks, the old structure will be excluded. Get creative and get in there. Our local GP fed is on the board of the STP. You make your own luck.

    Unsuitable or offensive? Report this comment

  • Lack of transparency, corruption and intrigue - until you hack the whole muck at the top of nhse, you won't get anywhere. That's the bitter truth and the whole truth. The crux is corruption and when we talk of nhse, we actually talk of people - slick mobsters who have government protection.

    Unsuitable or offensive? Report this comment

  • asked to see it locally and told "it"s just pages of management speak"

    Unsuitable or offensive? Report this comment

  • What about the GPs on CCG boards? Are they excluded too?

    Unsuitable or offensive? Report this comment

  • Diversify out of GP - Upskill and out/reduce financial dependency. Bad things are coming down.

    Unsuitable or offensive? Report this comment

  • Hope the same leaders who are being excluded have the balls to recommend non cooperation to the GPs for the first time .
    These are being drawn up to benefit guess who -GP's -guess again.
    Simply ignore their suggestions and inform these groups what primary care will so safely

    Unsuitable or offensive? Report this comment

  • @10:46 CCG boards are fending for themselves and protecting their own interests like ccg members forming hubs to their advantage at cost of millions to the NHS - look at Medway example of only one hub of 74 where ccg board members are sitting while all others are around 34000. GPs sitting in ccg's are not on our side - no way - they'll bury us if they can only make a buck out of it.

    Unsuitable or offensive? Report this comment

  • Serenity tranquility peace . STP 2,5 Dimethoxy-4-methylamphetamine . A hallucinogen. Says it all really.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    On one hand , one could give the benefit of doubt to this STP as Nigel mentioned 'hope' in his editorial , we should be always ready for more confrontations and non-cooperations. The battles are not over.
    My feeling is there will be 'winners' and 'losers' . Question is what is the majority ? What is the minority?

    Unsuitable or offensive? Report this comment

  • Anon @1046 - answer to your question is Yes - STP is going on without direct GB involvement round here - most we get is a clinical leaders forum for the chairs - the clinical lead on the STP board isnt local.
    Said many times GPs need be involved as providers and we are being ignored.

    Unsuitable or offensive? Report this comment

  • suspect STP is really a devious Trojan horse to introduce an American HMO type model hidden under management speak drivel as usual (and faux so called consultation) so our esteemed CEO's nasty little plan can proceed against the will of the electorate..who definitely expect the basic structure of the nhs should remain
    the bma must expose this to the light as this has to be discussed by the public..too much is happening without proper scrutiny.
    I am deeply suspicious of NHSE ..they have a sinister track record of furtive actions like the disgraceful care record fiasco( which has recently dropped) after NHSE pissed into the wind yet again more millions of precious nhs money that should be going on patient care.NHSE is a large unelected quango with no proper accountability.
    actually I am more than suspicious of NHSE..

    Has hunt or NHSE asked the electorate yet about whether this is what they want???(I can tell you 101%--no)..of course not because it is the path for takeovers by united health etc to make multimillions by providing an inadequate service.
    BMA--it really is time to wake up.
    not in my name.

    Unsuitable or offensive? Report this comment

  • This comment has been moderated.

  • GPs should stick with seeing patients. Enough with the big-headed delusions of grandure i.e managerial/political skills we do not have. Do what yoy are trained for. The 2004 contract assumed we can do more and look at the mess we are in! Let the big boys take over now cardigans.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say