News / All STPs to be published soon

Following today’s publication of a King’s Fund report on STPs, claims were made that the plans were shrouded in secrecy and could lead to the closure of some hospital services. In a series of interviews with local leaders, the fund heard complaints that national leaders wanted to ‘manage’ the STP narrative and not share plans until they had agreed to them.

However, Sir Bruce said: ‘I am sure there are things that could be learnt about the process. But when you are trying to improve care for patients across a whole system things are never going to be straightforward. It would be naïve to think otherwise. We need to keep our eye on the prize and that is better care for the people we serve.

‘Claims of secrecy have been overtaken by the fact that we’ve asked that all STPs are now published over the next few weeks. And the extra time this has provided has given local hospitals, GPs and mental health service leaders the time they need to develop a starting-point for local conversations.’

He added that around a third of the 44 STPs have been published, with the rest due to be shared with the public in the next few weeks to kick-start local discussions.

The King’s Fund report, Sustainability and transformation plans in the NHS, said tight deadlines had made it difficult to involve stakeholders, including patients, the public and NHS staff. Patients and the public had been ‘largely absent’ from the process, it said.

STPs faced other issues – processes were confused and deadlines and instructions from national bodies were unclear or changing. STPs lacked a governance structure and STP leaders had no formal authority.

At the same time, the complex structure of the NHS created by the Health and Social Care Act 2012, which emphasised competition, made collaboration between NHS organisations difficult. Some STPs were based on financial assumptions and projections that local leaders lacked confidence in because of the financial pressures on the service.

The fund called for greater involvement of the public and NHS staff; better governance; a change in NHS regulations to make collaboration easier; and stress testing of STPs to ensure they are credible.

King’s Fund chief executive Chris Ham (pictured) said that though the introduction of STPs had been beset by problems, it was vital the NHS ‘sticks with them’.

‘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.’

HFMA policy director Paul Briddock said many in the sector have been calling for a radical overhaul of services to make the NHS more sustainable. Most believed STPs were the vehicles to deliver this.

He added: ‘Given many STPs are in the early stages, today’s report from the King's Fund may point to slightly premature findings about how some of the changes will be implemented and realised. However, it is important that frontline staff and the public are involved, through public consultation, at the appropriate time and as any changes to service provision are considered. Yet, the current planning phase needs to be focused on positive collaboration and taking forward-thinking steps towards a fit-for-future NHS.'