The Sustainability And Transformation Plans: A Critical Assessment

This report assesses the published drafts for STP plans and it raises concerns around the credibility of the implementation measures outlined in the plans | Centre for Health and the Public Interest (CHPI)

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Image source: CHPI

Many members of the public, and even some politicians, are only just becoming aware of Sustainability and Transformation Plans, which were imposed in a policy directive from NHS England just 3 days before Christmas in 2015 as part of a major shake-up of the NHS. 1 The dramatic reorganisation of England’s NHS into 44 ‘footprint’ areas, and the requirement for all NHS bodies to collaborate with local government social service agencies on these new 5-year plans, seemed like NHS England’s best hope of balancing its budgets by 2020-21. But the variegated and inconsistent series of 44 documents that have been published since the end of October have clearly fallen far short of NHS England chief executive Simon Stevens’ hopes a year ago.

Read the full report here

Sustainable development guidance

The sustainable development unit has published revised guidance on writing management plans for sustainable development. The guidance, which is for use by providers of any size and commissioning groups has been updated in line with the current NHS standard contract. 

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The guidance is intended to support organisations to understand the key elements that make up a Sustainable Development Management Plan (SDMP). It also provides some advice on how organisations can develop their organisation’s SDMP.

Having a board approved Sustainable Development Management Plan (SDMP) is one of the cornerstones of the Sustainable Development Strategy and it is also an indicator in the Public Health Outcomes Framework.

Developing an SDMP (or equivalent) will help organisations to:

• Meet minimum legislative, contractual and mandatory requirements related to SD
• Save money through increased efficiency and resilience
• Ensure that health and wellbeing in the UK and beyond is protected and enhanced.
• Improve the environment in which care, or the functions of your organisation are        delivered, for service users and staff
• Have robust governance arrangements in place to monitor progress
• Demonstrate a good corporate reputation for sustainability
• Align SD requirements with the strategic objectives of your organisation.

Read the updated guidance here.

Doing justice to mental health in STPs

Claire Murdoch, the national director for mental health in England, recently argued that some sustainability and transformation plans (STPs) are failing to do ‘justice’ to mental health | Chris Naylor – The King’s Fund Blog

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Image source: Rowena Dugdale – Wellcome Images // CC BY-NC-ND 4.0

Ignoring the psychological aspects of health and wellbeing leads to some of the grossest inefficiencies in the health and care system. For example, we have estimated that in England, poor mental health drives up the annual cost of long-term physical health conditions by between £8 billion and £13 billion. The fact is – and it should hardly surprise us – that when people are struggling to deal with the social and emotional pressures in their lives, their physical health often deteriorates – and the impact of that is felt strongly in general practice, A&E and elsewhere. And yet all too often we act as if these issues should be of concern only to mental health professionals.

Leaders in some parts of the country are using the process of developing STPs as an opportunity to rethink the approach taken to mental health and wellbeing across their local systems, and are embedding mental health in every strand of their work. Those who haven’t yet done this risk missing a significant opportunity to use STPs to deliver better population health and better value.

Read the full blog post here

The latest news and publications on STPs

1.The King’s Fund – Sustainability and transformation plans in the NHS: How are they being developed in practice?

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Image source: The King’s Fund

Sustainability and transformation plans (STPs) have been developed by NHS and local government leaders in 44 parts of England. The plans offer a chance for health and social care leaders to work together to improve care and manage limited resources. But will they succeed where other initiatives have failed?

Read the full report here


2. The Guardian – Patients and staff shut out of NHS transformation plans

NHS plans that could lead to hospital and A&E closures have been kept secret from the public and barely involved frontline staff, a thinktank has said. NHS England has told local health leaders not to reveal the plans to the public or the media until they are finalised and have been approved by their own officials first, according to published documents and a new analysis by the King’s Fund.

Read the full news story here


3. GP Online – STPs ‘far from perfect’ but NHS has no plan B

Although the plans are ‘far from perfect’, they represent the only chance the NHS has to improve health and care services in the face of an ‘unpredecented slowdown in funding’, according to a King’s Fund report.

Read the article here


4. The King’s Fund Blog – Will STPs deliver the changes we wish see in our health and care services?

Sustainability and transformation plans (STPs) are based on the notion that collective action is needed to address the significant pressures now facing health and care services in England. Thelogic of this is sound – but developing the plans has been far from easy, and implementing them will require leaders and organisations across a local STP footprint to work together in new ways. In our new report, Sustainability and transformation plans in the NHS, we make a number of recommendations as to how leaders and organisations might do this.

Read the blog post here

Progress into the Implementation of the England Cancer Strategy: One Year On

All Party Parliamentary Group on Cancer & Macmillan Cancer Support | Published online: 23 September 2016

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Image source: Macmillan

In July 2015, the Independent Cancer Taskforce published its report Achieving WorldClass Cancer Outcomes: A Strategy for England 2015–2020 (the England Cancer Strategy). Following on from this in May 2016 NHS England published an Implementation Plan: Achieving World-Class Cancer Outcomes: Taking the strategy forward (the Implementation Plan) which outlined how the recommendations from the England Cancer Strategy will be rolled out nationwide. Following the publication of the Implementation Plan, the APPGC launched an inquiry into the progress made since the publication of the England Cancer Strategy. Having reviewed submissions from over 30 stakeholders and listened to oral evidence from those leading the implementation of the England Cancer Strategy, we have identified three key recommendations

This inquiry finds that, one year on from the publication of the England Cancer Strategy, there remains broad consensus amongst witnesses and respondents to the inquiry on its recommendations. This report outlines three recommendations on funding, transparency and accountability, and involvement of organisations with expertise and interest in cancer.

Read the full report here

NHS Shared Planning Guidance

NHS Operational Planning and Contracting Guidance 2017 – 2019

NHS England and NHS Improvement have published this year’s operational and contracting planning guidance three months earlier than normal to help local organisations plan more strategically.

For the first time, the planning guidance covers two financial years, to provide greater stability and support transformation. This is underpinned by a two-year tariff and two-year NHS Standard Contract.

It provides local NHS organisations with an update on the national priorities for 2017/18 and 2018/19, as well as updating on longer term financial challenges for local systems.

Key facts

  • The planning process has been built around Sustainable Transformation Plans so that the commitments and changes coming out of these plans translate fully into operational plans and contracts
  • The timetable has been brought forward to enable earlier agreement locally about contracts
  • Adjustments have been made to national levers such as tariff and CQUIN to support local systems in implementing service transformation
  • In line with our expectation of greater collaboration between organisations locally, there will be a single NHS England and NHS Improvement oversight process providing a unified interface with local organisations to ensure effective alignment of CCG and provider plans.