Question Local Health Leaders on NHS Plans

Next week Portsmouth residents have an opportunity to ask health and social care leaders questions on Hampshire and IOW Sustainable Transformation Plans (STP) setting out the future of local NHS services, at a public meeting called by Portsmouth Healthwatch. Editor in Chief, Sarah Cheverton reports.

In late December last year, S&C worked with a Portsmouth NHS doctor to report on the submission of “NHS plans and contracts for the next two years based on the Hampshire and IOW NHS Sustainability and Transformation Plan, known as STPs”:

STPs are 5 year plans for all aspects of NHS spending in England. 44 plans have been drawn up by health services, local authorities and health providers across the country, each one covering geographical areas known as ‘footprints’, and representing an average population of 1.2 million people. As well as covering NHS spending, each plan also has to show how NHS services can better integrate with local authority services such as adult social care – ‘known as place-based planning’ – and is expected to cover the period from October 2016 – March 2021.

Nationally, STPs have proved highly controversial with activists often referring to them as ‘Slash, Trash and Privatise’ plans.

…The STP for Portsmouth covers Hampshire and the Isle of Wight and responds to the financial pressure on NHS services in the region, most notably £577 million of NHS cuts required by 2020/21 compared to current levels of spending. This is alongside £192 million of cuts to adult social care across Hampshire, Southampton, Portsmouth, and IOW councils, creating a total of £769 million cut to the area’s NHS and social care by 2020/21.

The Hampshire and IOW STP includes proposals to cut 300 hospital beds across the region and to reduce the GP workload by 30% by shifting work to non-clinical staff.

Although the plans have been published on the websites of Portsmouth City Council and the NHS Portsmouth Clinical Commissioning Group, no public consultation on the proposals has taken place or yet been confirmed for the future.

On 7th February, Portsmouth Healthwatch are hosting a public meeting at St Mary’s Community Health Campus, inviting residents to put their questions about the STP to local health and social care leaders:

Members of the public are invited to join us at this meeting, where the Chair of Healthwatch Portsmouth will provide an opportunity for as many attendees as possible who wish to, to ask the invited speakers questions about the plans.

In addition, residents who cannot attend are invited to submit questions about the STP via email:

If you cannot make the meeting but have a specific question you are keen to ask, please email us at [email protected] and we’ll try to ask it on your behalf.

Portsmouth Healthwatch aims to help “people get the best out of their local health and social care services” by helping them “to influence the delivery and design of local services that they use” (Portsmouth Healthwatch website). It employs a team of three and is currently looking for a new Programme Manager.

The group is funded by Portsmouth City Council via a contract delivered by Learning Links, but overseen by a voluntary Board of local residents. It forms part of a network of 152 Local Healthwatch groups across the country formed under the 2012 Health & Social Care Act. 

The full draft of the STP clearly states that:

It is unlikely that formal consultation would be undertaken on something as all encompassing as the STP and across such a wide geography.

Instead, the STP highlights plans to ‘engage with’ local communities, but falls short of outlining any concrete ‘engagement’ plans, or confirming which ‘statutory body or bodies’ might be tasked with undertaking them:

Engagement about any proposed changes to existing services will continue to be carried out by the statutory body or bodies responsible for proposing the change, supported by relevant information from the STP. This will ensure that engagement is carried out at a local level and led by an organisation with which local people are already familiar, recognising that ‘Hampshire and the Isle of Wight’ is not a natural community of care and that people’s loyalty is to their own GP and local hospital and then to the wider NHS as a whole.

The STP summary report provides a little more detail on plans for ‘engagement and involvement with local people’, via Healthwatch and a series of roadshows:

…we plan to work with the four local Healthwatch organisations in Hampshire, Southampton, Portsmouth and the Isle of Wight on a period of further engagement and involvement with local people and local stakeholders about the ambitions in the plan and any refinements we can make. Healthwatch is the independent body that represents the voice of patients and public. We will kick this off with a series of road shows across Hampshire and the Isle of Wight early next year to talk about the plan and listen to the views, ideas and concerns of local people and voluntary and community groups and staff. Details of the road shows will be publicised in the New Year.

In December, Cllr Luke Stubbs called on Portsmouth Healthwatch to undertake a consultation on the plans, but this was rejected in a public statement released on the local Healthwatch website:

The responsibility for consultation on the STP rests with the NHS organisations and guidance on how this should be undertaken was published by the NHS in September 2016.

Healthwatch Portsmouth seeks to ensure that the public have an opportunity to shape and influence health and care services and we can advise on plans for engagement and link with other local Healthwatch in the area of the STP to support engagement activities where appropriate.

We are independent of the STP process and we believe there must be adequate time for any consultation to be credible and that proposals need to be communicated clearly so that people can understand them and be able to respond in a meaningful way.

In a letter last September to Conservative councillor for Eastney & Craneswater, Cllr Jennie Brent  –  also Chair of Portsmouth City Council’s Health Overview and Scrutiny Panel – Dr Jim Hogan, Chief Clinical Officer & Clinical Leader for NHS Portsmouth Clinical Commissioning Group, stated that:

Any specific proposals for significant future service changes which do emerge from our STP will go through a rigorous period of both clinical and public engagement, and indeed formal public consultation if that is appropriate, before any decisions are taken.

At the time of writing, S&C have been unable to confirm any plans for a public consultation – or dates for the engagement roadshows for early 2017 referred to in the STP draft summary – to enable Portsmouth residents to have their say on the proposals set out in the STP. The public meeting next Tuesday is the first opportunity local residents will have to ask questions directly to local health and social care leaders about the STP.

This report is part of S&C’s renewed focus on investigative, critical journalism and our exploration of how it can be funded without compromising editorial independence through advertising or ‘advertorial’ (articles that have been paid for by businesses for promotional purposes). All of our writers work for S&C for free, supported by a team of 2 volunteers currently giving 4 days a week to S&C unpaid. If you would like to see more in-depth coverage of local issues and news, please consider supporting our work as a donor or a volunteer, following the links below.

Find out more

Hampshire and Isle of Wight STP – read it for yourself and share it with your friends, colleagues and families

Healthwatch Portsmouth – Find out more about Healthwatch Portsmouth’s work, governance and funding in their 2015/2016 Annual Report

British Medical Journal blog – ‘Alex Scott-Samuel: Tory plans for NHS privatisation released during parliamentary recess’

Health Campaigns Together – crowd-sourced information on all STPs across the 44 ‘footprints’, including the Hampshire and IOW STP Summary, Appendices and supporting reports

Open Democracy – ‘Councillors must look before they leap into secret NHS cuts plans’

Support national and local campaigns calling for public information and involvement in NHS cuts

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