Dear NHS England Board Chair and Members
We have no confidence in you or the quango which you govern. Set up by the 2012 Health and Social Care Act, it lacks any democratic legitimacy since the Act was not in any party’s 2010 General Election. We call on you to resign before you destroy the NHS as a comprehensive, safe, high quality service that is free to all, based on their clinical need.
The so-called Sustainability and Transformation Plans which NHS England and NHS Improvement have imposed on NHS organisations are at best a fools’ errand. Their goal of imposing a balanced budget on the NHS, on the basis of a funding shortfall of at least £22bn by 2020/1, is impossible to achieve while maintaining the NHS as a comprehensive, safe, high quality service that is free to all on the basis of their clinical needs.
We see from the published STPs and from the effects of this first STP year that this circle cannot be squared. The attempt has already plunged the NHS into the deepest crisis in its long history.
Even one of the Footprint STP Leaders, Sir Andrew Cash, recently told the House of Lords NHS Sustainability committee that the NHS needs a yearly 4% funding increase; he was backed up in this by Dame Julie Moore, Chief Executive, University Hospitals Birmingham NHS Foundation Trust and Sir Michael Deegan, Chief Executive, Central Manchester University Hospitals NHS Foundation Trust.
If they are at best a fool’s errand, at worst the STPs are an attempt to feed the NHS and its great wealth to profiteering corporations - among them Simon Stevens’ and Matthew Swindells’ former employers, United Health and Cerner, respectively.
We are worried about this revolving door between corporate executives and NHS England executives.
Regarding Matthew Swindells’ appointment to NHS England from his position as Senior Vice President at the US health digitech company Cerner - a dominant supplier of electronic patient record systems to NHS hospitals - we are not reassured by NHS England’s statement that:
“Swindells will divest himself of any financial interests in his former employer, and recuse himself from any official dealings with them for the subsequent 12 months after taking up post.”
As soon as he took up his post as NHS England’s National Director for Commissioning Operations and Information, Matthew Swindells announced that digital technology “must be embedded in Sustainability and Transformation Plans”. £100 million “digital excellence awards” to 12 acute hospital trusts pays for systems that will work on patients’ smartphones or handheld devices, so that they can get medical advice and info without seeing their doctors or other NHS staff.
This is in line with Sustainability and Transformation Plan new models of care that copy the practices of Simon Stevens’ former employer United Health and its subsidiary Optum, as well as Cerner “population health” work that Matthew Swindells was involved in. We have no confidence in these new care models that the STPs say will make the NHS “sustainable” in the face of protracted government underfunding - which is an ideological choice, not an economic necessity. We deplore the secrecy with which the STPs have been developed.
Simon Stevens and Matthew Swindells learnt their trade as advisers to the Blair government, with its disregard for formal processes of accountability - as with the secretive Downing Street meeting in 2002 that originated the costly, wasteful and ultimately ineffective National Health Service IT Programme.
Now NHS England has kept the public, councillors, NHS Staff and Trades Unions in the dark about the 2017-19 STP operational plans, although the contracts to deliver them are due for sign off on 23rd December.
Most STPs have yet to disclose any financial details, but it is not in the public interest to impose harsh footprint financial control totals, that dwarf any contribution from the Sustainability and Transformation Fund. There will be severe consequences that will destabilise our NHS hospitals and services and risk patient safety.
In its first year, the STP has rendered CCGs assurance frameworks unfit for purpose, since many risks are now system-wide and so outside the control of the CCG. Several CCGs are now in financial turnaround, due to STPs’ impossible demands for "efficiency" cuts; and are unable to meet statutory requirements such as the referral to treatment time. As a result they are looking at how to reduce referrals and restrict access to many elective treatments.
There has been no consultation with the public, councillors, NHS staff and their trade unions on the STPs as a whole, the principles that underlie it or its devastating effects on the NHS and social care. Engagement exercises do not constitute consultation, nor is it possible to engage without transparency, including the full financial details of the STP.
But even if it were not already too late, leaders of the North East London (NEL) STP have told the Inner North East London joint health overview and scrutiny committee that consultation on an STP as a whole is not even possible, because it has not been proposed by a specific statutory organisation.
Because of NHS England’s role in reducing the NHS to a shambles and withholding information that should be public knowledge in a democracy, we have no confidence in the NHS England Board, the NHS England quango and all other organisations created by the 2012 Health and Social Care Act - for which we are now all reaping the whirlwind.
If you have the best interests of one of our greatest public institutions at heart, you will all resign now.
999 Call for NHS
Calderdale & Kirklees 999 Call for NHS
Friends of HRI
DONHS - Wirral
Barnsley Save Our NHS
Support Stafford Hospital
Sussex Defend the NHS
Cambridge Keep Our NHS Public
Fighting 4 Grantham Hospital
Gateshead Public Services Alliance
Save the Alex
Protect Chorley & South Ribble A&E
SOHS - Devon
Defend Our Community Services (DOCS)
Save the Horton
Merseyside People's Assembly
National Health Action Party
South Lincolnshire Green Party
Calderdale 38 Degrees NHS Campaign Group
We Need West Cumberland Hospital
Save South Tyneside Hospital
Shipley Labour Party
Whitstable Stop the Cuts
Unite Community Branch 11500
Fair Deal for the NHS
Coastal West Sussex 38 degrees NHS Group
Hands Off Our NHS
38 Degrees Manchester
Banbury National Health Action Party
Hands off Hinchingbrooke
Save Burton's A & E
Hands off the Horton
Waltham Forest Save Our NHS
Lincoln Green Party
Hands off the Horton
38 Degrees Halifax
Alston Moor Parish Council Health CampaignGroup
Durham Labour Left
Keep Our NHS Public Dorset
Nottingham Keep Our NHS Public
West Oxfordshire 38 Degrees
Save Wycombe Hospital
North Kirklees NHS Support Group
Upper Colne Valley HandsoffHRI
38 Degrees - Airedale and Skipton
38 Degrees Haringey
Boston Focus Group
North North East London Save our NHS
38D North Wiltshire
Lewes Stop TTIP
Amber Valley KONP
Defend our NHS York
Wirral West Liberal Democrats
Hull Save our NHS
Save South Tyneside Hospital
Darlington Green Party
Oxfordshire Keep Our NHS Public
Sheffield Save Our NHS
Who joined the campaign community in calling for the resignation of the NHS England Board in a loud howl of "no confidence".
We will keep you posted as to the journey of the letter.
A separate page listing the names of those who took the trouble to sign.