In the letter to the Mayor - the first joint public criticism of the process by the bodies - the RCN and the BMA call on Sadiq Khan to take a greater role in protecting health services in the NHS Sustainability and Transformation Proposals (STP).
The letter states that patients and clinicians are currently ‘after-thoughts’ in the proposals, heavily criticises the lack of transparency and accountability and says people across London are currently ‘left in the dark’ about the future of health services.
It comes after a report in September for the Mayor on London’s STPs found ‘unachievable savings targets’ and ‘neither desirable nor credible’ plans to cut the number of hospital beds in the capital.
London’s five NHS STP areas have been asked to make savings of over £4 billion and the professions say it is unclear how these financial targets will be met without damaging patient care. Three of London’s STPs are among the most financially challenged in the country and have been placed under the Capped Expenditure Process (CEP), a system whereby NHS England and NHS Improvement put tighter spending controls on providers deemed to be ‘overspending’.
The letter asks the Mayor to seek the following assurances that London’s STP leadership will:
- Commit to meaningfully engage with the healthcare workforce at every stage of the transformation;
- Put transparency at the heart of decision making and publish full details of all proposals;
- Ensure all service changes are supported by clinical evidence;
RCN London Board Chair Cynthia Davis, said:
“Nurses and doctors in London are sending a clear message that they will no longer be ignored during the STP process or remain silent when financial targets are prioritised over patient care.
“STPs represent the biggest change to the health service since its birth – it is time that the input of clinicians and the public was recognised as being fundamental to making sure this change can be safely delivered.
“Unfortunately, we are still seeing parts of London being asked to make eye-watering savings without any clear evidence adequate services will remain in place. Doctors, nurses and above all patients need the Mayor to use his voice and standing in the city to demand better from those charged with delivering STPs.”
BMA London regional council chair, Dr Gary Marlowe, said:
“These plans are being rushed through at a worrying speed without the necessary transparency and governance to ensure they will improve the delivery of patient care as opposed to being a vehicle for plugging funding gaps.
“Changes of this magnitude must be clinician-led and have the relevant public engagement to ensure that that patients and front line services are not jeopardised.”
You can read the full version of the letter to the Mayor here.