King’s Fund report backs controversial STPs for NHS

STPs for NHS nurse arms folded

A report published today by The King’s Fund says Sustainability and Transformation Plans – STPs – for the NHS are the right way forward despite issues

Despite criticising the controversial Sustainability and Transformation Plans (STPs), a report released today by health think tank The King’s Fund finds that STPs for the NHS are indeed the right way forward.

The report says that STPs offer the “best hope” for improving health and care services, despite patchy or absent involvement from local government, clinicians, frontline NHS staff, the public and patient groups.

Under development in 44 areas of England, STPs are roadmaps for the future of health and care services which have been strongly criticised by politicians, local authority leaders and patient groups. The new report is based on interviews with senior leaders in four STP areas and reiterates many of these criticisms.

STPs for NHS: No plan B

“The introduction of STPs has been beset by problems and has been frustrating for many of those involved, but it is vital that we stick with them,” commented Chris Ham, chief executive of The King’s Fund.

“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. 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.”

This point was reiterated in an opinion piece from health writer Roy Lilley, who wrote:

“STPs are not the new kids on the block. They are the only kids on the block; to see us though the life and death weeks that we have left.”

The report found STP lead struggling with “a confused process”, with unclear or changing deadlines and instructions from national NHS bodies and a lack of governance structure or formal authority for STP leaders.

Hard work of local leaders 

In spite of these difficulties, the document urges the government and NHS to continue to back STPs and set outs a number of recommendations to improve the way they work. These include the need for:

  • all parts of the health and care system, as well as the public, to be involved;
  • improved governance, with the role of STP leaders strengthened and clarified, and NHS regulation changed to make it easier for organisations to work collaboratively;
  • national bodies in the NHS to ‘stress test’ STPs to ensure the assumptions behind them are credible and proposed changes realistic.

“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,” Ham added. “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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