2 min read

Editorial Wednesday 2 March 2016: What's the difference for NHS managers between an STP and an STI?

Surprise, surprise: there are loads of vacant clinical jobs, while providers are finding their own workarounds for the agency staff cap/ban.

Meanwhile, hospitals have been asking councils (who have seen real-terms budget cuts of about a third, with the same again to come) for 80% of their business rates back.

And new analysis from the Health Foundation concludes that system-wide problems are driving the deficits.

What a good time to be having a fight with junior doctors.

I'm irresistibly reminded of visiting an amusement park back in the 1980s, before heath and safety was much of a thing. A recorded announcement on what to do in the event of a fire on the ride prompted a lugubrious attendant to remark, "in the event of a fire on the ride, put your head between your legs and kiss your arse goodbye".

For want of a plumber, BMA House was lost
The junior doctors' contract dispute went from sad to hearse, with the latest leak to HSJ's emergency plumber Shaun Lintern.

The BMA's lawyers advised their client that their expensive attempt at judicial review stands little chance of successfully preventing implementation if the DH belatedly conducts an equality impact assessment, and might at best offer a bargaining chip leading to an  opportunity to renew negotiations if the JR were not publicly announced.

Can you guess what the BMA JDC then did?

Oh. You can.


This matters, because only two parties could have leaked that to Shaun.

One would be the BMA's lawyers (whose reputations would be toast if they did such a thing).

The other would be someone in the BMA who's noticed just how badly the dispute is being handled by junior doctors' leaders, and who wants to make them look even more explicitly silly and tactically and strategically counter-productive.

Mission accomplished, whoever you are.

Stabilisation and Transformation Plans: not trendy
The latest TLA (three-letter acronym - do keep up!) to delight the NHS is STP - Stabilisation and Transformation Plans. It seems that NHS Improvement CE Jim Mackey doesn't want STPs to be "trendy".

Unfashionable plans? That feels like a new national target that shouldn't be too hard to hit.

In principle, strategic plans are good and needful things.

In practice, NHS funding doesn't work, and another plan isn't about to make it do so. The Amy Winehouse Fund hands extra financial levers of control to NHS England (The Artist Formerly Known As The NHS Commissioning Board) and NHS Improvement (The Artist Formerly Known As Monitor And The TDA).

The timeline to produce full draft STPs from 23 December to 8 February was, as Rob Findlay noted, not wildly serious.

HSJ news editor Dave West's analysis is good on other weaknesses, including the emerging 'Life, The Universe And Everything' answer of 42 local geographical footprints.

Still, you know what they say about the difference between an STP and an STI: at least senior NHS managers treat their STIs seriously.