STPs will need a change in law to succeed, says report

A report from London Southbank University argues that in order to deliver a better future for the NHS, all 44 STPs would need to be given legislative powers and support necessary to achieve effective collaboration, plus some much-needed clarification on their role | NHS England

STP LSBU

Image source: LSBU

We commissioned this report as a reality check on the Sustainability and Transformation Plan process as a whole; to provide an opportunity for review; and to reconvene around the issues that need a sub-regional approach.

This report is a significant contribution to the myths and realities of the Sustainability and Transformation Plans and the process of their development. By starting from the actual situation in each STP footprint, this report grounds the plans in the reality of the local context, and provides a firm basis for any collective decision-making. Many of the STPs (the documents) are not clear about the full extent of the current situation (the baseline from which they are making their plans), which makes the collective STP leadership task extremely difficult.

 

STP governance and engagement

NHS Clinical Commissioners and NHS England have published CCG lay members, non-executive directors and STP governance and engagement. 

This briefing brings together ideas from four workshops organised in February 2017 for lay members on CCG governing bodies and non-executive directors from NHS Trusts.  The report reflects the discussions that took place on issues such as the importance of governance and accountability and developing working relationships across STP footprints.

The report also sets out some recommendations from NHS England and NHS Improvement which include:.

  • Consider a central online resource showcasing examples of national good practice.
  • Consider the governance and engagement issues relating to the development of accountable care systems.
  • Take a coordinated approach to embedding the role of lay members and NEDs in sustainability and transformation partnerships.

It also includes next steps and actions for lay members/NEDs, national bodies and STP leads which are intended to support the successful implementation of STP and new models of care.

Read the report here

Mental health and new care models

GPs need to prioritise mental health more, say experts. | Mental health and new models of care | Kings Fund | OnMedica

While some of the vanguard sites developing new care models report promising early results from adopting a whole-person approach, the full opportunities to improve care through integrated approaches to mental health have not yet been realised.
This Kings Fund report draws on recent research with vanguard sites in England, conducted in partnership with the Royal College of Psychiatrists. The report found that where new models of care have been used to remove the barriers between mental health and other parts of the health system, local professionals saw this as being highly valuable in improving care for patients and service users. But there remains much to be done to fully embed mental health into integrated care teams, primary care, urgent and emergency care pathways, and in work on population health.

The main vehicle for rolling out what vanguards are trying to achieve are England’s sustainability and transformation plans (STPs) and there are concerns, said the authors, that some STPs had limited content on mental health.

‘It is vital that STP leaders are encouraged to make mental health a central part of their plans, and that they are able to take heed of the emerging lessons from vanguard sites,’ says the report.

More mental health support is needed in GP surgeries, said the authors. They recommend strengthening mental health capabilities in the primary and community health workforce by improving the confidence, competence and skills of GPs, integrated care teams and others.

State Of Child Health: Sustainability And Transformation Partnerships

Following analysis of STPs, this report argues that the plans are failing to take into account the needs of infants, child and young people | Royal College of Paediatrics and Child Health

state child health

Image source: RCPCH

It finds that while most STPs set out the case for change well and cover important key themes such as prevention, early intervention, more care delivered in the community, better mental health services and integrated working, there is a lack of detail underpinning the vision. It concludes that the lack of profile given to infants, children and young people (who comprise 25 per cent of the UK population) by the majority of STPs, is a cause for concern.

STPs: who, what, why, when, where

BMJ Talk Medicine | Published online: 8 April 2017

The NHS Delivery Plan – setting out what’s in store of the English NHS in the coming years, has been delivered by Simon Stevens the chief executive. Key to those are the sustainability and transformation plans (STPs) which have been made in 44 areas, and yet again reorganise care – crucially, this time, with social care included in the mix.

In this podcast Hugh Alderwick, senior policy advisor at the King’s Fund explains what STPs are, and what they’re planning, and crucially, the cash involved.

Related article available here

BBC analysis of STPs: Hospital cuts planned in most of England

Hospital services in nearly two-thirds of England could be cut or scaled back, BBC analysis of local plans shows.

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The BBC analysis found:

  • Plans to reduce the number of hospital sites in Leicester, Leicestershire and Rutland from three to two
  • In the Black Country a £700m funding gap means one hospital may have to be closed
  • Maternity and children’s services being “centralised” on to one site in Lincolnshire
  • A warning in West Yorkshire and Harrogate that having five hyper-acute stroke services may “no longer be viable”
  • The downgrading of two out of three A&Es in Mid and South Essex, with only one retaining specialist emergency care
  • In South West London, proposals to reduce the number of major hospitals from five to four
  • Plans in Nottinghamshire to significantly downsize City Hospital and reduce the number of beds across Nottingham by 200
  • In Cambridgeshire and Peterborough, consideration being given to centralising specialised orthopaedic trauma services at two local hospitals

Overall, a third of the 44 plans look to reduce the number of hospitals providing emergency care, while in another third of areas they have said they will consider moving non-emergency care to fewer sites.

Read the full analysis here