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The Effects of Sustainablity & Transformation Plans

Already the STPs mean withdrawal and restriction of treatments - particularly so-called “over the counter” products like special feeding for the frail and elderly, and treatments like hip replacements and cataract removal that are not life saving but if not provided, leave people in pain and with disabilities.

Closing/downgrading A&E and other acute hospital services

STPs are not just about closing or downgrading a full accident and emergency unit or other acute hospital cuts and closures - although a Health Service Journal survey of clinical commissioning groups shows that a “substantial minority” of STPs will do this. They are about totally changing the way in which NHS England operates and functions. And that effects all of us across the country.

Destroying the patient-doctor relationship

There will be far fewer hospital beds, and more care at home via interactive digital technology, etc.  They are trying to convince us that this is based on evidence - where is this evidence?

 

The whole patient - doctor relationship will be undone. Many important GP and community services formerly provided in hospitals will be delivered by huge “ GP Federations” in a number of “hubs” that cover very big populations and provide standardised “care pathways” or “managed care” for various illnesses.  With extreme budget control.

Copying American private health  insurance schemes, “care pathways” dictate to doctors what treatments they care allowed to give - undermining their vocational skills and all NHS Ethics.

 

STPS are forcing all the footprint regions to cut millions from their services. Under the guise of "efficiency savings" this "financial reset" is a cruel and deceitful way of justifying government underfunding and, more worryingly, a move toward 'managed care' and a two tier health system akin to the USA model.

 

This enables care to be delivered by new grades of less skilled, cheaper staff.

The STPs place a big reliance on unskilled voluntary sector people,

family and friends, as well as on patients themselves managing their own care.  

The cost savings from this will be big - meaning more profit.

 

To help create the right conditions for fee-paying health and profits, the STPs place a big reliance on unskilled voluntary sector people, family and friends, as well as on patients themselves managing their own care.  

Again the cost savings from this will be big - meaning more profit. 

Patient self management 

STPs are big on pushing preventative care and keeping people out of hospitals. That's because in an insurance system hospitals are seen as expensive. So the STPs will divide patients into groups according to their financial risk.

 

The lowest risk groups will be subject to “preventive” care aimed at changing their behaviour to become more healthy and teaching them to “self manage” their illness - ignoring all the social, environmental and economic determinants of ill health and the fact that these are outside individuals’ control.

 

Already GPs are “inviting” their patients to register for self-management courses run by companies like Self Management UK

 

 

 

 

 

 

This is about taking the “care” out of health care, to cut costs.

But we are the sixth richest country in the world. We can perfectly well afford a proper NHS. Why doesn't the government want to provide one?

 

PROFIT MAKING COMPANIES HAVE EATEN THEIR WAY INTO OUR NHS PSYCHE.

SELF CARE 1 SELF CARE 2

Incentive to cherry pick most “cost effective” patients

Copied from the USA "managed care" model  the "care closer to home" schemes in the big GP/community hubs that replace many hospital services will be funded on a per capita basis for a given population - ie what the insurance company thinks your health is worth. Are you "cost-effective"?

 

Organisations that hold the contracts for the "care closer to home" schemes and primary/community care hubs will aim to make a profit.  All of this undermines the principle of a comprehensive health service.

And are GPs on board with all this?

In November 2016 BMA London Region said that half of the members had never even heard of STPs.

 

 

 

 

 

 

A twitter survey of GPs and Practice managers found that 84% didn’t know what is in their area’s STP about General Practice/Primary care. No one else knows either - if we are to believe replies from Council Leaders to members of the public who have asked them to publish the STP for their area.  

 

Of course, NHS England and almost all the NHS & Local Authority organisations involved in the STPs are spinning them as being about improvement to the quality of NHS and social care services and reduction of health inequalities through preventive care.

 

Don’t believe the spin.

BMA GPs & STP ACOs - what are they?

Accountable Care

Organisations (ACO)

It can be incredibly difficult to decipher the new terms, acronyms and language that NHS England likes to throw at us.

 

Accountable Care Organisations - another USA model - are basically where the STPs are heading. All the 44 STPS mention it in their documents and NHS England has announced there will be trials from April 1st 2017.

 

ACOs will cement the USA model of health insurance care.

 

Find out about Accountable Care Organisations - ACOs. A major feature of the STPs.