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STPs promise huge change and potential benefits - but at what costs?

 Teresa Budrey 15 Dec 2016 Eastern

In recent weeks reams of information about the future of the NHS in our region has been published online. If you’ve missed them, you’re not alone. The majority of the public is probably unaware of the huge changes about to be set in action as part of the so-called Sustainability and Transformation Plans (STPs).

The Royal College of Nursing has been busy analysing these documents, trying to glean from their many pages what the effect will be on patients and our nurses and healthcare assistants. This has not been an easy task. The majority of the plans – six which cover the Eastern region – are grand in their overall aims but vague in detail.

They all talk about the need to change the way health services are delivered in the face of huge deficits running into billions of pounds within five years if nothing is done. They talk about preventing ill health, treating people closer to home and out of hospital wherever possible, making sure patients get the right care in the best place. All very laudable objectives.

But how they go about this is a bit less clear, and as the plans continue to be developed in the coming months the RCN will be doing all it can to be part of these discussions and making sure the voice of nurses is heard.

Because so far nurses and nursing are not topics which form a huge part of any of these plans. Despite the huge role played by nurses and healthcare assistants in delivering care, much of what we learn from the STP documents about nursing is from reading between the lines. Greater collaboration across multiple sites = nurses having to travel to work at different locations. New health roles = nurses potentially being replaced by other, cheaper health staff. Expanded work responsibilities = new aspects being added to nursing workloads.

What is clear is that without additional funding, the new STPs risk failure. To save money in the longer term, investment is first needed to help put in place what will ultimately be big changes to the ways we deliver healthcare.

Any changes to the number of registered nurse roles as part of the plans would be of great concern to the RCN, which is why it is crucial we are involved in their formation. This has not been possible so far as the process has been rushed - STPs developed in secrecy and isolation.

On paper these plans are very ambitious in their aim of preventing avoidable ill health, joining up services and delivering a greater proportion of care close to or in people’s homes. The reality is that hundreds of hospital beds will be cut and yet community health and social care services are simply not geared up to cope with displaced demand.

Staff and patients must be reassured by the government that STPs aren’t simply for driving forward cuts to services and costs. The government can do this by acting now and funding health and social care properly. We will continue to push for what is best for patients and our nursing staff.

Photo of Teresa Budrey,  Regional Director, Eastern Region

Teresa Budrey

Regional Director, Eastern region

Teresa joined the RCN in 2003 as an officer in the Eastern region, following 20 years working in NHS learning disabilities nursing services. Teresa went on to become a senior officer in the RCN’s South East office before returning to the Eastern office in 2016 as operational manager.  She was appointed as Eastern Regional Director in February 2017.