Skip to main content

Delivery costs extra: can STPs survive without the funding they need?

England’s health service is under increasing strain. For too long the Government has been underfunding the NHS, resulting in a predicted £30 billion funding gap each year by 2020/21. This is exacerbated by both the cuts facing social care and a lack of adequate investment in public health across the UK, which will inevitably make the situation worse in the future.

This is all in the context of an ageing population, with greater numbers of people living longer with more disability and often with two or more long term conditions. Difficulties with recruiting and retaining staff are another major challenge. BMA members report rota gaps and vacancies, an increasing number of GPs about to retire and potential additional challenges to securing staff in the aftermath of the UK’s decision to leave the European Union.

Increasing demand, tight funding and workforce challenges all mean that across England the state of the health system is precarious. The future of general practice is under threat, with unprecedented increases in workload, shortages in GPs, and historic and continued underinvestment. The situation is equally challenging in secondary care, with significant reductions in bed numbers in recent years and trusts struggling with huge deficits.

This is the background in which STPs (Sustainability and Transformation Plans) have been introduced and gives some idea of the level of the challenge they face to resolve the crisis in our NHS. This paper follows up on some of the BMA’s public facing work on STPs over the last six months (see below for more information). It considers objectively what STPs are trying to achieve locally and evaluates both the direction of travel and chance of success. This should give members the necessary information to consider their own STP in a more informed way and hold their leads to account. The BMA is committed to monitoring the content and progress of STPs.