Plans to shake up the NHS in Northamptonshire and cut funding by £328 per person were put in place “by stealth” according to a national campaign group - and could face a legal challenge.
The National Health Action Party - which claims it is fighting to save the NHS from being turned into a US-style health service - believes the Sustainability Transformation Plan (STP) proposals appear to run contrary to the provisions of the Health and Social Care Act. It says the STPs are contrary to the stated objective of the Act, a locally driven commissioning service provided by GPs who have an intimate knowledge of their local community needs.
In response to a parliamentary question last year, life sciences minister George Freeman admitted any plans submitted “have no status until they are agreed.”
However, an NHS campaign group believes changes are being put in place by “stealth” with no explanation as to their purpose.
Deborah Harrington and Jessica Ormerod from the National Health Action Party’s campaign team said: “We have watched and reported to our members on the unfolding story of the STPs with some horror, taking whatever action we can to highlight the damage being done to the NHS.
“It is a statutory requirement that major service changes to the NHS are backed by good clinical evidence - which increasingly they are not - but also by a legal framework that allows for accountability.
“Where is this legal accountability in the STP leadership arrangement?”
Ron Mendel, a University of Northampton lecturer and NHS activist, sat on the Nene Clinical Commissioning Group patient congress while the plans were being drawn up.
But when asked whether he thought the plans were produced “behind closed doors,” he said, “Definitely.”
By October, a month before the STP plans were published, he said some GPs he had been in contact with had not even heard of the STPs, such was the lack of publicity.
He said: “There was no patient consultation, no public engagement whatsoever.
“NHS England said they couldn’t even get us a summary when we asked.
“We never knew how any impact was being taken forwards, there was never any feedback.
“The loop was never closed.
“We were never really consulted. I had to keep pushing as a patient activist find out more about the STP.
“There were never written reports, it was always verbal.
“We never saw anything in writing.”
The National Health Action Party campaign group said two-thirds of local authorities reported being excluded from decisions about the STP leadership and campaign groups around the country have reported what they say is a “shocking lack of knowledge about STPs” from their local councillors.
“Yet again this raises the question of accountability which is a crucial component of any lawful process involving service change to the NHS,” the campaign group said.
“One specific area of concern is the creation of Accountable Care Organisations, private companies which will hold the budgets, including the Clinical Commissioning Group budgets, with boards drawn from a variety of NHS, private sector and local authority bodies.
“Accountable Care Organisations are based on the US system of healthcare. Where is the legislation for this?
Nene Clinical Commissioning Group, part of the STP blueprint for Northamptonshire, said the plan is still at this stage, a “high-level” strategy.
“The next stage for us is to turn that strategy into the operational plans that will deliver the proposed changes,” the spokeswoman added.
“Engagement will continue with local people, doctors and other professionals – such as, health and social care staff, local councils, the voluntary sector, communities and groups - to develop individual service changes in detail when we reach that next stage.
“We will continue to keep our population informed about what opportunities there will be to engage with and shape the plan and the way it is delivered as and when the plan develops further. It is important to stress that any major changes to services would have to go through formal consultation before they could happen.”
An NHS England spokesman said: “All the STP proposals were published before Christmas.
“These documents are the starting point for a conversation. All areas have been asked to intensify their engagement with patients, the public and staff as they work to turn ideas into plans.”