The Somerset Sustainability and Transformation Plan (STP) produced by the Clinical Commissioning Group and Somerset County Council aims to achieve a “sustainable and transformed health and care system for the people of Somerset”.
The STP currently lacks details, and some of it is obscured by the use of jargon, but the direction of travel is explicit:
The background for Somerset against which this plan has been devised is as follows.
Given the rurality and the population age profile it is difficult to understand how the assumptions about closing community hospital beds and shifting care into people’s own homes will be successful in reducing costs. Is there family support available? from the demographic profile it looks likely to be very limited. Occasional visits from staff, having to travel significant distances between homes is not likely to prove adequate to keep people at home. How cost effective is it in very rural areas where the ratio of time spent travelling v providing care will be high. The costs may go down for the NHS / Social services- but at an increase in costs to the individual and their carers. This assumption is alarming given the increase in the very old. The concentration of some services into 1 of the 2 hospitals in Somerset takes no account of the knock on costs to the Ambulance Service of having to travel longer distances. There will also be a cost to the individual, and to family / friends visiting.
There is a systematic undermining by Government actions of the efforts across the NHS to reduce expenditure. On prevention for example, the Government has recently watered down the proposed obesity strategy and refuses to initiate a minimum price per alcohol unit. It has recently been announced that the Government is selling a majority stake in NHS Professionals (agency for staff) to the private sector- when with severe challenges to workforce there is already a huge spend on agency staff so losing the one NHS agency into a for profit organisation will not help; either costs will go up or pay to staff will go down leading to more demoralisation / lack of staff availability. Add Brexit and lack of support for EU staff so retention / recruitment form the EU is also at risk and the already precarious staffing situation can only get worse. There is an increase in the number of Nursing / Residential homes closing because of inadequate funds from Local Authorities to pay for beds / staff costs. With an increase in the “living wage” this is going to get worse, and the knock on impact is further difficulties in discharging hospital patients who need a nursing home bed.
Meantime, after no additional funding announce in the Autumn Statement NHS England has advised NHS Trusts to pass on some scheduled surgery to the private sector to ease a potential winter crisis.
To quote Bevan, “The NHS will last as long as there are folk left with faith to fight for it.” Are you willing to fight for it? Are we willing to invest in our NHS? Ask your MP what they are doing about it.
For more detail on the STP see:
A paper copy of the STP is available via email from: STPfeedback@somersetccg.nhs.uk