How England’s Sustainability and Transformation Plans Will Affect Doctors

Planned closures under the National Health Service (NHS) in England including emergency departments, GP care and ward closures, first emerged a year ago under a draft of the Sustainability and Transformation Plans. The plans are local health and care reform plans which divide England into 44 areas with each area tasked to develop proposals to reduce spending, and give local leaders and communities increased control over improvements to health and social care. The main aim is to save £22bn by 2020-21 as part of the NHS Five Year Forward View.

Of greatest concern is the proposed closing of Emergency Departments, known as Accident and Emergency or A&E departments in England in a cost-cutting measure that is expected to affect around 23 million people in the UK. NHS managers proposing the changes claim there will be a boost to community services but the British Medical Association says the changes are being rushed through without sufficient evidence. There has also been criticism about the funds spent on salaries for managers to implement the plan at a time when the British Medical Association feels the money would be better spent on more GPs, junior doctors and medical specialist consultants.
locum gp holding a stethoscope imprinted with a new zealand flag

Plans currently include closing or downgrading 18 emergency departments, closing or merging hospitals in 14 areas, and closing some hospital beds in 13 areas. The plans are a partnership between NHS England and local councils, designed to improve health care for the population in the individual areas. The NHS says the proposed changes will allow for longer GP opening, make it easier for patients to see GPs, provide more coordinated care, and centralise specialist hospital care to make such services more efficient.

In May this year the Royal College of Paediatrics and Child Health released a short report on the 44 Sustainability and Transformation Plans which found there was limited recognition of the needs of children and young people in the majority of STPs, little acknowledgement of child health services and insufficient consultation with healthcare professionals working in the specialty. There were also concerns about workforce shortages due to rising hospital admissions for children and that such shortages had not been addressed in most STPs.

A few of the Sustainability and Transformation Partnerships are beginning to evolve into Accountable Care Systems (ACS), in other areas further community consultation is planned before the changes are fully implemented.