Sustainability and transformation partnerships

MQT on 2017-12-14
Session date: 
December 14, 2017
Question By: 
Onkar Sahota
Labour Group
Asked Of: 
The Mayor


How will the recent Health and Social Care Devolution deal impact the implementation of sustainability and transformation partnerships (STPs) in London and how is the London Health Board measuring the success of the implementation against the six assurances to be met before STPs receive Mayoral support?


Answer for Sustainability and transformation partnerships

Answer for Sustainability and transformation partnerships

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  Thank you.  The ground-breaking devolution agreement I agreed with the Secretary of State [for Health], Jeremy Hunt MP, London Councils, the NHS, Public Health and wider health and care leaders will bring health and care services closer together, localising decision‑making to London to bring improvements to the services Londoners receive.  It is a very important step in the right direction in our journey to becoming the world’s healthiest global city.  In future, the NHS in London will be incentivised to sell unused land and buildings.  It is one of the largest landowners in London with money reinvested in health and care community and public services.  Surplus land will be available to develop more housing.  The London Health Board, which I chair, is the body that will provide political oversight of the developments in health and care across the city. 


With respect to the King’s Fund report [Sustainability and transformation plans in London: an independent analysis of the October 2016 STPs} and the six assurances that I set out, I have accepted the recommendations for me to provide system leadership, to sustainability and transformation partnerships.  To this end, my Mayoral Health Advisor, Dr Tom Coffey OBE, and GLA officers are currently discussing with STP leaders and the wider NHS the options to secure their commitment to ensuring greater democratic transparency of the proposed implementation plans. 


Dr Onkar Sahota AM:  Mr Mayor, first of all I want to congratulate you for commissioning the report from the King’s Fund because this is the first time we are looking objectively at what is happening in London, rather than the previous Mayor saying, “I have been informed XYZ”.  I congratulate you for that.  The challenge, of course, is that this report is very critical of what has happened across London.  You have asked for six assurances and I want to know, if those assurances are not being given to you, what you can do about it.  While the STPs are being questioned, the clinical commissioning groups (CCGs) are still implementing some of the direction of travel of those STPs.  Damage is being done as we speak, right across London.  I want to know what you want to do now you have the report on your desk. 


Sadiq Khan (Mayor of London):  A number of things.  First, we cannot run away from the fact that the NHS in London is underfunded by £4.1 billion.  Secondly, one of the reasons why many people believe that STPs are making the decisions they are is to save money.  Thirdly, their plans do not equate to the projections of our population and the needs we have as a city.  I have made it quite clear to STPs that I can only support their plans if they satisfy the six assurances.  The good news is that some of the STPs are now undertaking refreshes in light of the King’s Fund report.  I would encourage all of the STPs to refresh what they are doing in light of the King’s Fund report.  They are saying to us that they are already doing some of these things.  For the interests of transparency, they should do it sooner rather than later and let people know. 


Dr Onkar Sahota AM:  One of the worst STPs is in northwest London, in my part of the world, and they are not refreshing.  Of course, we know the boroughs of Ealing and Hammersmith and Fulham have not signed up to those STPs.  I really want to push you on this.  If they do not do this refresh, what other steps can you take?


Sadiq Khan (Mayor of London):  We will not support their plans.  As the Mayor of London, as someone who is chair of the Health Board, that will carry a lot of weight.  I meet directly with the person in charge of NHS London, NHS England, Professor Jane Cummings.  She will understand our views in relation to this.  A good STP understands that if they want to serve the community they need to take key stakeholders with them, including councils.  I would be disappointed if STPs ignored the six assurances set out by the King’s Fund.


Dr Onkar Sahota AM:  Thank you for that, Mr Mayor.  The other thing, of course, is that the London Health Board is a very important body through which you want to do extra scrutiny work and also make sure to give leadership to London.  One of the criticisms of the Health Board has been that it is not transparent.  Can you tell us what you want to do to make it more transparent, please?


Sadiq Khan (Mayor of London):  I know these guys do not like talking about the previous administration, but before I was the Mayor there were no minutes published and no records kept publicly of what the Health Board was doing.  They had selective amnesia.  We are now publishing the minutes of all Health Board meetings and we are looking towards how we can make it even more transparent.  It is not acceptable for men and women to meet in closed rooms and make decisions that no one knows about.  We are trying to see how we can be more transparent as we go forward. 


Dr Onkar Sahota AM:  Great.  That would be very helpful, Mr Mayor, and I look forward to seeing it become much more transparent.