Sustainability and transformation partnerships lose many nurses in maze of 'acronym spaghetti'
RCN gives evidence to the Health and Social Care Committee stating that one quarter of nurses had not engaged with the sustainability and transformation partnerships process
RCN gives evidence to the Health and Social Care Committee stating that three quarters of nurses had not engaged with the sustainability and transformation partnerships (STPs) process
- Many nurses concerned about how STPs would affect working terms and conditions
- Workforce lacks time to engage with the process
- STPs described as complex and surrounded by 'acronym spaghetti'
The RCN told MPs that it had surveyed nursing staff at all 44 STP sites in England but found only one quarter had engaged with the process.
RCN assistant director of policy Lara Carmona revealed the finding while giving evidence on 27 February to the Health and Social Care Committee. Its latest inquiry is looking into STPs as many prepare to evolve into integrated care systems.
STPs have been in development since 2016 and involve NHS and local council representatives joining together to plan and improve health and social care in their areas.
'Good engagement is difficult'
Integrated care systems will see certain groups working even closer together within an existing STP, and from April will gain even greater flexibility over their finances and commissioning of services.
Asked a question by MPs about how much workforce engagement there has been in the process so far, Ms Carmona said: ‘I would love to say something beautifully positive.
‘Good engagement is difficult, it’s hard because you have to have very difficult conversations.
‘If you want nurses to engage in an active process you have to come to them early, and often, and you have to go to where the people are having these conversations.
‘I personally put a call out to our staff and I went to see them, and three quarters have not participated in the STP process locally.
‘For the most part, what came back was a fear and an uncertainty around employment terms and conditions.
‘STPs clearly will involve changes to the way that people work.’
Need for protected time
British Medical Association council chair Chaand Nagpaul told the committee: ‘Most of the workforce have not got time to engage.
‘Doctors and nurses are overstretched, so if you want them to contribute their clinical value to the process then you need to give them protected time to go and do that.
‘These are the people who deliver care day in and day out on the coalface.’
Risk of compromising patient safety
Ms Carmona said that making changes purely on the basis of efficiency ‘runs the risk of compromising patient safety to a degree that’s unacceptable’ as well as ‘putting our workforce in conditions which are untenable’.
She added: ‘None of the STPs which are out there have the level of detail we would expect to see in terms of transparency, particularly in workforce planning.’
Committee chair Sarah Wollaston admitted the STP processs was complex and coined the term ‘acronym spaghetti’ to describe the various plans by which the government and NHS are attempting to integrate health and social care.
A RCN spokesperson confirmed the survey Ms Carmona referred to is due to be published in full at a later date.
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