More work needed on STPs, says HFMA

27 February 2018

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In its submission to the Commons Health Committee inquiry into STPs, the association said its members broadly agreed that the system-based approach was the right direction of travel.

However, the advent of STPs marked a significant change in working practices – replacing the competition of the internal market with collaboration.

In the latest HFMA NHS financial temperature check, finance directors said relationships between commissioners and providers had improved overall, but further work was needed to strengthen ties with GPs, local authorities, ambulance trusts and the voluntary sector. Engagement with the public, patients and staff was mixed and a lack of transparency had led many members of these groups to view STPs as a vehicle for cost-cutting.

The fact that STPs are not statutory bodies creates potential barriers to collaboration. Individual organisations remain accountable for the delivery of services and their financial targets.

The HFMA evidence reiterated finance directors’ concerns about STP governance because of this lack of alignment. It also highlighted concerns about STPs’ ability to deliver a plan to help close the funding gap by 2021 and finance leads’ fears that transformation is being hindered by the operational split between NHS England and NHS Improvement and current operational pressures.