STPs ‘need more funding and to be better implemented’

21 Sep 17

Sustainability and transformation partnerships need more funding and to be better implemented, the Healthcare Financial Management Association/CIPFA health and social care conference heard today.

The partnerships are the best hope for health and social care integration, Richard Humphries, a senior policy fellow from the think-tank the King’s Fund, told delegates at the conference in London.

“The ambitions of the plans are good but the delivery and implementation is fraught with problems in the current financial climate," he said. 

“I think everybody agrees that we do need to transform social care but history tells us that the only way you do that is to have transformational funding for the double running costs of building up services in the community so you can then reduce hospital activity.”

He added: “The existing system is fragmented, based on commissioners and providers. Nobody wants another top-down reorganisation to reverse those [current] reforms.

“So [greater integration] is being done through the backdoor, essentially, through these STPs.”

Humphries believed STPs were the “right direction of travel” but noted that there were issues.

He outlined the following problems:


  • The STPs are being driven by NHS financial control, which he said was "unrealistic"
  • There are "heroic assumptions" being made about how much care you can shift out of hospitals
  • The plans are not engaging local government and social care enough.


Humphries said: “Although it is a laudable motive, the current structures that we’ve got in both commissioning and providers, separation, funding, payment mechanisms was designed from an entirely different purpose when it was based on the idea of competition and choice being much more important than collaboration.”

The conference also heard the findings from a survey conducted by CIPFA and iMPOWER. It showed 55 of 56 respondents said they did not believe joint working will be achieved between local government and the NHS in the next five years.

Rob Whiteman, CIPFA's chief executive, commenting on the survey of 25 local authorities and 31 NHS bodies, said: “While it is now clear what the overall ambitions are for STPs, the survey released today highlights there may be major barriers to achieving these.

“The survey shows that there are some significant concerns with regard to joint working, which is vital to the success of STPs. Therefore, serious care and attention must now be paid to building relationships and trust between partners.”

Whiteman also echoed the sentiment of Humphries when he said suitable levels of funding were needed, or the ambitious targets set by the STPs would turn out to be “financially unachievable”.

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