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Councils reject NHS plans due to lack of GP investment

Two councils in England have rejected regional plans to overhaul NHS services because they fail to pledge sufficient investment in general practice.

Shropshire Council and Telford and Wrekin Council in the West Midlands have said that they are ‘unlikely to approve the [sustainability and transformation plan] in its current form’ because not enough resources were promised to primary care.

In a statement, the councils said that they believed resources should be put into primary care services as well as community services, rather than into secondary care.

The Shropshire and Telford and Wrekin NHS STP, which has a predicted deficit of £131.4m by 2021, is planning to reconfigure hospital services to create one centre of emergency care and another in ‘routine surgery or planned care’.

But both councils said following the STP’s publication on Monday that they have been left ‘with a lack of confidence in the financial projections and the reliability of the rationale for future cost reductions’.

The councils’ statement said: ‘[I]t is the shared view that significantly more resources should be put into prevention and reconfiguration of community and primary care services, rather than reconfiguration of hospital services.’

Malcolm Pate, leader of Shropshire Council, said: ‘NHS England have instigated a “launch” of the STP, which suggests the plans have been fully worked through and agreed by all parties.

‘Unfortunately, this is not the case, as it is the opinion of both Shropshire Council and Telford and Wrekin Council that some elements of the document need developing.’

But Shrewsbury and Telford Hospitals NHS Trust chief executive Simon Wright, who leads on the STP, said the plan was ‘not a final detailed plan of how we want to change things’ but ‘represents the views and aspirations of the organisations involved’.

He said: ‘We will take all of these ideas to the patients who use our services and our own workforce. We’ll be talking more about this in the coming months [and] will only take forward proposals which will support the long-term future of our NHS and will benefit our patients.’

NHS England tasked regional teams, CCGs, trusts and local authorities to write ‘sustainability and transformation’ plans outlining how the NHS Five Year Forward View would be put into action at the start of 2016.

Although Pulse revealed that GPs were left largely in the dark throughout the first six months of the planning process, NHS England has said it would not approve any plan that does not support general practice.

What are the sustainability and transformation plans proposing?

Pulse’s scrutiny of the 44 STPs have previously revealed how:

  • GPs in one region of England may have to shoulder an increasing burden of patient care  following the merger of two acute care trusts in Nottinghamshire;
  • In Dorset, a plan for the sustainability of the local NHS suggests that a current 98 GP practices, operating at 135 sites, ‘will over-stretch’ local ‘workforce and finances’. It suggests that a ‘reduction in the number of sites’ would lead to a better provision of services ‘for more hours of the day and days of the week’;
  • In Hampshire and Isle of Wight, a reduction in GP workload by almost a third is sought, while also significantly reducing patients’ face-to-face contact with primary care.
  • 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.
  • In East Devon, more than half of community hospital beds could be closed.
  • NHS managers are expecting GPs in one area of England to slash their prescribing costs by a ‘very ambitious’ 15%, while another is targeting 7%.