STPs are the right approach but public and staff engagement now need stepping up

14 November 2016

Based on a series of interviews with senior NHS and local government leaders, a new report from The King's Fund looks at how sustainability and transformation plans (STPs) have been developed in four parts of the country.

The report found that despite the focus on local ownership, key elements of the process have been 'top-down', and the approaches of national bodies and their regional teams have not always been aligned. 

The report makes a number of recommendations for the future of the STP process. It says there is a need to secure the meaningful involvement of patients and the public in STPs, alongside clinicians, other frontline staff and local authorities, as well as develop governance arrangements that allow organisations to make collective decisions and share accountability. 

Commenting on the report, Saffron Cordery, director of policy and strategy at NHS Providers, said:

“The NHS and social care need to work more closely together if we are to provide better care and outcomes for patients and service users. The STP process is an important way of helping to bring together what are often fragmented services. But as the King’s Fund report says, there are concerns that need to be addressed if the plans are to succeed.

The NHS and social care need to work more closely together if we are to provide better care and outcomes for patients and service users

“The level of engagement with patients and the public now needs to be stepped up. The plans need to make the case for change and then work through options with local communities. It is better to engage local people and their elected representatives as early as possible in the process when changing the way care is delivered to patients, rather than presenting them with a set of fixed solutions. This should also be the case when it comes to engaging with staff and, in the case of foundation trusts, governors. The plans also need to strengthen the involvement of those in local councils who have sometimes been disengaged from the process.

It is better to engage local people and their elected representatives as early as possible, rather than presenting them with a set of fixed solution

“The leadership of the NHS is relying heavily on the STPs to deliver savings, but they are being developed at rapid pace and within timescales that are at best ambitious. While the principles behind STPs are absolutely correct, NHS trusts and foundation trusts tell us the speed with which these plans have had to be developed, and the pressure to produce plans that financially balance across the 44 regional areas, mean many of the assumptions contained within them are unrealistic. We need more time to test assumptions thoroughly before delivery.”