‘NHS cuts planned across England’. That headline from a recent BBC website article is typical of much recent media coverage of proposed changes to health and social care services and how they are funded. It is vital that we understand exactly what is proposed and what it means for us.

We all know that these services face very severe financial problems, and many of the reasons for this would exist regardless of who was in government.

England has been divided into 44 areas - or ‘footprints’ in official jargon. Each has been tasked with producing a ‘sustainability and transformation plan’ to work out how services will be delivered in the future.

We are in a ‘footprint’ made up of Hertfordshire and West Essex, and the NHS and two county councils have submitted their plan to NHS England to say how services will evolve and become sustainable in the next five years.

Healthwatch Hertfordshire fully supports the idea of planning for the future and trying to make services more efficient and responsive to changing social needs. We do, however, have serious concerns about the way these plans have been developed.

Public and patient involvement has been lacking, in contrast with most recent practice in Hertfordshire, e.g. the public and community engagement programme in the west of the county around ‘Your Care Your Future’ consultation.

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It needs to be said that this is the responsibility of national, not local, NHS leaders.

Not so long ago the official slogan was ‘No decisions about you without you’. The best thought out plans will not work unless they carry the support and understanding of the public.

We are also concerned that frontline staff have had insufficient involvement and that insufficient attention has been given to developing closer links between health and social care which might save not just money, but more importantly, lives.

It is not clear how and by whom decisions are being taken. The STP cuts across existing boundaries of representative bodies, like local councils who seem to have little influence on what is happening.

How will the ‘governance’ (to use another bit of jargon) relate to existing selected bodies and those organisations that run the NHS in Hertfordshire?

The secrecy imposed by NHS England is not helpful. Now that some STP plans have been published it is time the rest, especially the Herts and West Essex plan, follow suit.

We understand that many changes have to take place and that not all of these will be universally welcomed, but in order for the people of Hertfordshire - and indeed England - to trust that this process is being carried out with their best interests at heart it must be transparent, accountable and above all answerable to every one of us who use and rely on these services.

Michael Downing, Chairman, Healthwatch Hertfordshire