Developing sustainable primary care

Challenges facing general practice are increasing. This comes at a time of increased patient need, high demand for services and growing challenges in retaining and recruiting clinical team members | PCC


PCC has been supporting practices to prepare for the future by looking at ways they can become more sustainable. From our work so far, the following themes have emerged:

  • The need to ensure practices are well run, claiming appropriately and considering how the practice, as a whole, could work smarter.
  • Planning for the future –how a practice will need to change in the next three to five years and how steps towards this can start now, to achieve early wins and boost morale.

General practices are responding to the increasing demands they face in several ways. Some are merging with other like-minded practices or working with other partners in the health economy. Others are collaborating to share back office or clinical skills to enable them to manage patients and workloads most appropriately. This includes signposting to alternative local services.

Read the full overview 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. 


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.

NHS finance

The House of Commons Library has published The financial sustainability of the NHS in England.

This briefing provides background on the current funding settlement for the NHS in England, the financial and operational performance of the health service, and measures being taken to ensure its future sustainability, including Sustainability and Transformation Plans. It also provides background on the Department of Health’s Annual Report and Accounts for 2015/16 and ongoing select committee scrutiny of NHS funding.

Financial sustainability of the NHS

The National Audit Office has published Financial sustainability of the NHS.


Image source:

This is the fifth report on the financial sustainability of the NHS produce by the National Audit Office. This report highlights that with more than two-thirds of trusts in deficit in 2015-16 and an increasing number of clinical commissioning groups unable to keep their spending within budget, the financial problems are endemic and this is not sustainable.

Additional link: Kings Fund press release

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?


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

The State of health care and adult social care

The Care Quality Commission (CQC) has published The state of health care and adult social care in England 2015/16.

This annual report provides an overview of health and social care in England looking at trends, highlighting examples of good and outstanding care, and identifying factors that maintain high-quality care.

It finds that most services provide people with good care, but variation exists. Some care services are closing, increasing pressure on other services including GPs and hospitals.  The report highlights that the sustainability of the adult social care market is approaching a tipping point.

Additional links:  CQC press release | Health Foundation

Is the NHS financially sustainable?

Latest updates from the Nuffield Trust

NHS Framework Documant 2008

The NHS is going through a decade of austerity, but demand for health care continues to rise. Clearly, the NHS needs more money in the short term, but what about the future?

This is the subject of a House of Lords inquiry into the sustainability of the health service up to 2030. New spending projections from the Office for Budget Responsibility estimate a rise in public spending to 8.8 per cent of GDP in 15 years. In analysis of the estimates, John Appleby argues that it will be possible to fully fund the NHS in the future. The bigger question is who will pay for it.