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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.’