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GP sustainability plans are ‘undeliverable’, MPs warned



Regional sustainability and transformation plans (STPs), which have to secure the future of general practice across England, will fail because they are ‘vastly overambitious’, MPs have been warned.

Chris Hopson, the chief executive of NHS Providers, told the House of Commons Health Committee that nearly every member of NHS Providers is working on undeliverable plans to meet their 2020/21 financial allocation set out by NHS England.

Mr Hopson said members asked NHS England over the summer whether they could submit ‘any plan’ that met the funding requirements or if a realistic plan that outlined ‘how far we can get’ would suffice. But they were told they were ‘not allowed to submit a plan that doesn’t balance to that 2021 figure’.

Mr Hopson told MPs: ‘So our members are saying to us that they are spending quite a lot of time creating plans that in their view are not deliverable and usually involve major structural service changes because that is the only way that they can create a balanced plan.

‘Our view is that that really risks blowing up and destroying a process that actually seems to us to have a huge amount of fundamentally positive benefits. And that is a consistent story that we’re getting from virtually all of our members.’

Mr Hopson warned the amount of savings targeted were ‘scary’ in parts of England, which are facing funding gaps of ‘hundreds of millions of pounds’.

He said that providers ‘are now looking at a set of figures, which to be frank, just look completely undeliverable’ and ‘what that means is people are coming up with vastly overambitious plans that either rely on vastly overambitious demand management plans or, more often, service reconfigurations’.

‘But to be frank they’re not going to happen because they won’t command the required political support and there simply isn’t the capital available,’ he added.

According to Mr Hopson, NHS providers are not opposed to system reconfiguration to meet targets, but are looking for ‘a realistic stretch’.

He said: ‘Our members are asking: please do not force us to come up with undeliverable, silly plans because you’re focusing on this financial gap.’

The Department of Health announced in the NHS Spending Review that investment growth in the NHS would slow from a 1.3% growth in 2017/18 to 0.3% in 2018/19 and 0.7% in 2019/20.

The news comes as Pulse reports today on a £500m STP savings plan that aims to shift workload to GPs and merge two acute trusts.

In other areas of the country, GP surgery numbers are being slashed as part of long-term plans to make savings.

In north London, practices with list sizes under 10,000 patients could face closure amid moves to create primary care ‘hubs’ with lists of 30,000.

And in the South-West, Dorset is looking to reduce the number of primary care sites in a bid to keep remaining services open for more hours and days of the week.