London STP efficiency targets ‘unrealistic’

12 Sep 17

Plans drawn up to improve health care in the capital have unrealistic targets for reducing costs, according to a joint report. 

The NHS in London faces a potential funding gap of £4.1bn by 2020/21, the King’s Fund and Nuffield Trust have said in their report on London’s five published sustainability and transformation plans.

The aim is to reduce this gap to £650m.

Speaking at the launch of Sustainability and transformation plans in London yesterday, Chris Ham, chief executive of The King’s Fund, said: “Our analysis found a worrying lack of detail on how this gap would be filled and unrealistic assumptions about the level of efficiency savings that could be delivered.”

At the current rate of hospital use the impact of demographic changes alone may require 1,600 to 1,700 extra acute hospital beds in London by 2020/21, the report also stated.

“This is unlikely to be affordable and there would be difficulties in recruiting the extra staff needed,” the report suggested.

This proposed reduction in hospital use and cutting bed numbers was “not credible”, said the joint review.

This was “even if additional investment is made in services in the community”.

“Heroic efforts will be needed simply to manage rising demand with existing hospital capacity,” it added.

The bulk of the savings are expected to come from provider efficiencies and shifting care to the community.

The report also praised aspects of the proposals, such as their focus on prevention and early intervention.

Ham said at the launch: “Despite these reservations, we believe that STPs offer the best hope for the NHS and its partners to plan together for the future.”

But he added: “As in the rest of England, much more needs to be done in London to engage with partners in local government and other sectors and to involve patients and staff.”

The report called for the mayor of London to take on an oversight role for health care in the city to drive collaboration between NHS organisations, local authorities and other stake holders.

In response Sadiq Khan has said he wants to “champion and challenge” the NHS in London and he set out his provisos for support the STPs.

He said: “Any plans around the future of NHS services in London must be given proper investment, and must not have an adverse impact on health inequalities, social care or hospital capacity.”

The joint study was completed in March but its publication was delayed due to the general election. 

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