Making STPs A Reality: Action to Deliver Better Care

Sustainable Transformation Plans (STPs) represent a significant shift in the way health and social care services are planned and delivered. Rather than provider competition strengthening choice and quality of care NHS organisations have been instructed to deliver place-based planning that co-ordinate a range of services and providers around patient needs. This means different parts of the NHS and social care system working collaboratively in order to meet the challenges facing local services. This shift in thinking recognises the growing financial, demographic and workforce pressures affecting the NHS that cannot be addressed in isolation. Care providers, commissions and supporting agencies need to collectively manage the combined resources for NHS Services for their local population. STP footprints commonly cover large areas and involve many different organisations and providers, each with their own priorities, challenges and cultures. So how can local plans be developed in practice so that collaboration and integration is embedded in the local care system and benefits, such as improved patient outcomes or financial savings, are realised?

All STPs include proposals to strengthen primary and community services and to integrate NHS and social care more closely. An additional £390 million over three years has been allocated to delivering STPs in the spring budget so that plans can be progressed. The key themes in STPs include strengthening prevention and early intervention; improving mental health and other services such as cancer; changing the role of acute and community hospitals; developing organisational arrangements to support ambitions to transform services; and developing productivity and tackling unwanted variations in care. STPs also give attention to the changes needed in NHS infrastructure, such as IT systems and NHS buildings. New models of health and social care also need to recognise workforce development and skills capacity, there are ambitions to improve staff recruitment and retention, reduce agency costs, and develop new skills and roles that can deliver more integrated care. In order to reduce demand on acute services there are opportunities to manage care more effectively in the community by redesigning primary care and commissioning community services that closely integrate health and social care. STPs are actively encouraging GPs to work together at greater scale and deliver a wide range of services in the community.

Although local plans outline NHS ambitions to improve the health and wellbeing of the populations they serve they have not been without controversy. Plans have been criticised for cutting front-line services, not involving the public or patients and primarily focused on reducing NHS budget deficits rather than transforming the way care is delivered. There is pressure on local STP leaders to show how plans will bring NHS finances back into balance alongside detailing how plans will be delivered in practice. Immediate priorities will be to equip staff with the skills and resources needed to implement the improvements in care outlined in the local plans. Leadership and governance of STPs at a local level will also need to be strengthened to drive through required change, the challenge ahead is how to now make the plans a reality.

Making STPs a Reality: Action to Deliver Better Care will support care providers, commissioners and local councils improve health and care in their area. Our conference agenda has been designed to help organisations drive better quality and more sustainable health care services and explore how to collaborate to deliver improved population health and wellbeing.