NHS England has criticised regional plans to overhaul health services in the East Midlands for failing to support general practice.
The Leicester, Leicestershire and Rutland sustainability and transformation plan (STP) was called out by local NHS England officials for failing to set out how the general practice resilience programme – pledged in last year’s GP Forward View – would be rolled out in the region.
STP leaders said it received NHS England’s feedback, unveiled in NHS Leicester City CCG board papers, in response to plans submitted in October and this had prompted amendments to the public document released a month later.
But the latest STP draft continues to fail to mention the programme, with LLR LMC chief executive Dr Chris Hewitt suggesting this was due to a lack of input from GP leaders.
He said: ‘From what I gather, they’ve got a team now working on different sections of the STP and all of those people in that team are full-time managers or full-time clinicians, who are struggling to do it, if I’m honest.’
Pulse warned in August that GPs were being ‘excluded’ from the STP process, and a recent BMA survey found that two thirds of doctors had not been consulted over the 44 wide-ranging plans to overhaul healthcare services across England.
At the time, NHS England told Pulse it would not sign off STPs that were not supportive of GPs.
Other criticism of the LLR STP included the need for more detail on supporting seven-day access, a lack of focus on primary care workforce retention and ‘concern that GPs were not actively involved in the development of the STP’.
But Dr Hewitt said: ‘It’s going in the right direction. GPs are getting more involved.
‘They have increased the focus on the primary care element and put a senior leader in from one of the CCGs, so there are good signs, some welcome signs.’
An STP spokesperson said: ‘Our engagement with stakeholders including GPs and others will continue to inform the content and detail of our draft STP as we move forward.’
The LLR STP says the area faces a combined health and social care deficit of £399.3m by 2020/21 if the system does not change.
But healthcare leaders have promised £18.5m by 2020/21 towards implementing the GP Forward View.
The RCGP has scrutinised the 44 STPs, finding that general practice is ‘frequently seen as a solution to problems in secondary care, without sufficient efforts made to stabilise and support it’.
Its report, published last month, also warned that NHS England has failed to implement measures pledged in the GP Forward View to support practices in danger of closing.
What are STPs proposing?
Pulse’s scrutiny of the 44 STPs, which have been drawn up by CCGs, councils and NHS trusts around England, have previously revealed how:
- NHS managers in one area of England are planning to reduce the number of GP appointments by over a quarter by sending more patients to other healthcare professionals.
- 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.
- Almost half of GPs could retire or cut hours in the West Midlands in the next five years.
- 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%.
- Every practice in Cornwall could be moved onto a new voluntary GP contract by 2020/21.
- Some 14 STPs have proposed investment to support the GP Forward View, totalling £394m.