Research from the King's Fund indicates STPs have a high risk of Failure. Despite the introduction of the Sustainability and Transformation Fund, the financial reset and the use of a new financial `special measures’ regime, financial performance in providers continues to slide.
As a result, reducing the net provider deficit to £250 million from the forecast £644 million at quarter one looks increasingly unlikely and indeed, there are greater risks it will rise rather than fall. This is despite a quarter of all trusts now reporting delays or cancellations of capital spending in order to support their finances.
Staff redundancies included in efficiency savingsThe latest Quarterly Monitoring Report from the King's Fund think-tank shows that increasing numbers of health trusts in England are also looking to reduce their clinical workforce, with 29 per cent now planning to reduce their headcount.
Mental Health staff cuts targeted mostWhile relatively few acute hospitals plan to reduce the number of staff, more than half of mental health and community health service providers are now planning to cut staff numbers. This threatens the aspirations to raise the quality of care set out in the Five year forward view for mental health as well as long-term goals to improve services in community settings.
Alongside cuts to capital spending by trusts, more than half of CCGs are delaying or cancelling spending plans. This underlines the risks that the drive to cut deficits is having on the long-term transformation agenda for the NHS.
Unachievable savingsLooking forward to 2020/21, the STP process has not led to any greater optimism about the prospects for achieving the £22 billion in efficiency savings needed to deliver the STP/Forward View. While some 79 per cent of trust finance directors think there is a high or very high risk of failure, now 90 per cent of CCG finance directors say the same, sharply more pessimistic than in July before STP plans were submitted or the planning guidance issued.
STP funding withheld
With many organisations still expecting to end this year in deficit, no additional transformation funding available, and minimal real-terms growth in 2017/18 and 2018/19, NHS finance directors have found little to be optimistic about.