News / STP direction driven by financial pressure

At the HFMA/CIPFA integration conference in September, Mr Humphries said STPs were based initially on three foundations – working collaboratively to meet the population needs; population-based budgets; and an outcomes-based approach. But the pressure to reduce spending in hospital had shifted the emphasis.

‘STPs are being increasingly driven by financial control totals for the NHS, which is not realistic,’ he said. ‘There are assumptions on how much care can be shifted from hospitals that are heroic and not based on evidence. 

‘There has been engagement with local authority social care, but there has not been enough.’

Mr Humphries (pictured) said the government is seeking integration by 2020. ‘Given that it’s been government policy for more than 40 years, I think that’s the triumph of hope over experience.’

A survey of 31 NHS and 25 local authority finance leaders on integration, commissioned by CIPFA, was published at the conference. Finance staff said there was a strong belief that their organisation’s sustainability would rely on collaboration across health and social care. 

Nine in 10 respondents said it would improve the patient/client experience, 70% said it would lead to better care; and just under two-thirds said it would produce non-cashable productivity improvements.

However, less than a quarter of the respondents said the relationships between local NHS bodies and councils were very strong, though there was a general view that they had improved over the last year.

Almost all respondents (95%) said it was essential or important to invest in prevention in the next three years. 

Public Health England chief executive Duncan Selbie highlighted the need for investment in prevention in its widest sense and collaboration between all aspects of the public and voluntary sectors. He said that a number of factors impact on a person’s ability to live long and in good health.

Of these, only 10% to 20% relate to how much is spent on health services. The rest were due to factors such as inequality, educational level and whether they were employed or unemployed.