King’s Fund highlights problems with NHS sustainability and transformation plans

14 Nov 16

Efforts to create sustainability and transformation plans across the NHS in England have been “beset by problems”, but the process still represents the best hope to improve health and care services, according to the King’s Fund.

In an examination of the development of the STPs, which are being developed in 44 footprints across England, the health think-tank highlighted a series of problems with the development of the plans.

These include “patchy” involvement of local government, as well as limited engagement with NHS clinicians and frontline staff and with patients and the public.

Today’s report, which is based on interviews with senior leaders in four STP areas, also found that many are struggling with a confused process, with unclear or changing deadlines and instructions from national NHS bodies. There is also a lack of governance structure or formal authority for the leaders of process, which led one chief to describe their role as being like ‘operating in a sea of fog’.

The blueprints are intended to bring together health and care leaders, organisations and communities to develop local proposals for improved health, care and finances.

Under a plan published by NHS England and NHS Improvement, each STP area will be able to apply for their own system-wide financial control totals. This is intended to make it easier for them to pool resources across organisations and shift money to support improvement of care and the redesign of services.

Chris Ham, chief executive of the King’s Fund, said introduction of STPs has been frustrating for many of those involved. However, he said it was vital that the sector sticks with them.

“For all the difficulties over the last few months, their focus on organisations in each area working together is the right approach for improving care and meeting the needs of an ageing population,” he stated. “It is also clear that our health and care system is under unprecedented pressure, and if STPs do not work then there is no plan B.

“The progress made so far has only happened because of the hard work of local leaders who have been prepared to work around the difficulties. It is vital that NHS national bodies learn the lessons so far, so that we can see STPs fulfil their potential.”

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