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Cambridgeshire and Peterborough STP

 Chris Hill 19 Sep 2017

Ever since sustainability and transformation partnerships (STPs) were first muted, the RCN has been clear about the need for unions to be fully involved in the process.

This isn’t just for the benefit of the members we represent, but also the patients they care for.

It was therefore welcome news when Matthew Winn, chief executive of Cambridgeshire Community Services and also STP lead for Cambs and Peterborough STP, told our regional director Teresa Budrey that unions would have a place on the Local Workforce Advisory Board (LWABs) involved in the process. Since its publication, the RCN has monitored progression of the STP with interest. We have learnt that Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) will become the Accountable Care System going forward and local GPs, together with Peterborough Hospital, will use CPFT’s governance and legal framework for future plans within the STP template.

Essentially this means that CPFT - despite having similar staffing challenges to other acute trusts - are consulting on service redesign around older people and mental health services that will not involve mergers of organisations.

But our RCN representatives have made it known to trust management that staff morale is low due to the level of consultations currently being undertaken by CPFT.

I have asked for the trust to invest in a listening exercise with us and other unions to look into the impact of changes being discussed and made on staff. Cambridgeshire and Peterborough STP is not alone in needing to make sure that staff remain fully involved and informed in changes being made. The pace or change and the savings which have been touted will undoubtedly cause stress and anxiety to many of our members and staff as a whole.

At the same time patients have also been told they face a minimum waiting time of 12 weeks for non-urgent treatment as part of money-saving tactics.

According to reports, the measure is part of a Capped Expenditure Process (CEP) which was introduced by NHS England in April for 14 areas of the country facing a significant financial deficit. The county’s clinical commissioning group (CCG) expects a deficit of £15.5 million in 2017/18, but only if it makes financial improvements of £46.4 million in-year.

Jonathan Dunk, acting chief officer of the Cambridgeshire and Peterborough CCG, said they were reviewing a number of initiatives as part of the CEP including introducing minimum waiting times across the CCG for non-urgent cases, but ensuring that patients are still treated within the NHS Constitution 18-week target.

He also spoke about strengthening the CCG self-care policy, ensuring clinical policies are properly and consistently applied, and joint work between primary and secondary care clinicians to review clinical pathways with the aim of reducing outpatient activity where this is of low clinical value.

Last November, the CCG revealed its STPs which aims to tackle an expected £500 million deficit over the following four years.

Recent conversations at the Social Partnership Forum at the CCG have highlighted the urgency and concern the RCN has regarding workforce in all of the STP plans. There remains a fundamental risk to the STP without a stronger retention plan for existing staff within the health system.

We will continue to watch what is happening within the CCG and STP, and make sure we use our place on the LWAB for the benefit of our members and patients.