NHS, Sustainability & Transformation Plans
There has been a lot of talk across the NHS about STPs (Sustainability & Transformation Plans) in the last few weeks. While people have put an enormous amount of effort to get them to where they are now, things are about to get really serious. STP – Starting to panic?
People we have spoken to fall into two categories – either they think that STPs are “a profound change”, or they are “just another plan”.
The recent editorial in Health Policy Insight clarifies this. STP’s aren’t really “plans” at all. They are just “sketchy first drafts”. The radical thing about them is not what they say, but the new relationships that underpin them. One trust chair spoke about the difference being about having “the right people in the right room grappling with the right questions” which allows “working as a system, not as individual institutions”.
The other feature of STPs is their sheer diversity. They vary in quality, they vary in clinical leadership and they vary in how much local authorities are engaged. Generally, engagement is a problem – with both staff and the public.
While there has been real progress, the challenges remain massive. There is no money (revenue, or capital). There is no time. It feels that to make an STP work you have to assume that all the things that the NHS has been trying to do for the last 10 years (treat people closer to home, specialise secondary care) will happen tomorrow.
As STPs move from planning into consultation and, soon, into implementation, things will get really tough. At Verita we have a lot of experience in working with commissioners and trusts in sorting out this sort of management issue. We are looking forward to the contribution that we can make to the process in the next few months.