STPs Sutainability and Transformation Plans
- Local health and care systems have come together in 44 footprints to produce a multi-year Sustainability and Transformation Plan (STP) showing how together they will improve services and achieve aggregate financial balance over the next five years – in effect, delivering their own local plans for implementing the Five Year Forward View.
- The focus should be on confronting the big challenges and taking the critical decisions that have previously been set aside. It is also about building the leadership coalition necessary to implement these decisions. Developing a shared plan is a by-product of this collective leadership, not an end in itself.
- STPs will not always be the most appropriate footprint on which to plan for every service. They are not intended to replace more local planning, or planning that needs to occur across STP boundaries – for example, for specialised services or urgent and emergency care networks. Subsidiarity is an important principle and STP leaders will have to make judgements about what unit of planning is most appropriate for each purpose.
1. What are the guides for?
- We promised a range of support for STP leaders to consider as they develop their plans; each footprint is receiving a data pack which brings together the most important indicators to help in assessing their current position against each of the three gaps (health and wellbeing, care and quality, and finance).
- This package contains guides to help local leaders work together in tackling the big system challenges, and build on existing efforts to make progress on some of our most challenging clinical priorities. Each guide sets out what success would look like in 2020. We also make suggestions about how areas could approach implementation. Wherever possible, we have linked to further detail.
- The guides included in this package are short – generally two pages on each topic. They distil guidance or information from other publications. They do not contain new asks or priorities; instead, they are more of an ‘aide-mémoire’ for STP leaders and their teams. They are a description of the top-line objectives we collectively need to achieve by the end of the decade, both nationally and locally.
- STP areas will already have strong plans in relation to some of these topics, in which case the guides may merely serve as a way of double-checking that core priorities have been considered. Local areas’ planning on other topics may be less advanced; in which case we hope these resources will be a valuable ‘short cut’. We do not expect footprints to cover off every point set out in all guides.
- There are some areas where we will be producing more detailed guidance to help with specific parts of the planning process. This includes material to help areas consider how they might develop devolution proposals and Local Digital Roadmaps.
- We want these to be helpful. We would welcome feedback on whether they are and, if so, whether there are other topics we should cover in a second batch of guides (e.g. workforce and safety). Feedback can be provided to your contacts in regional teams or email@example.com.
2. Accessing expert support
- To bring this material to life we are organising a series of optional events. These will be an opportunity to discuss how you are shaping your thinking on key priorities together with other STP leadership teams. There will also be the chance to engage national experts face-to-face, enlisting their help in thinking about how you can develop and deliver your plans. These events will be designed to facilitate practical discussions.
3. NHS funding
- When developing plans in these areas, and on other topics, footprints should consider how changes to services and shifts in investment, can lead to efficiencies, as well as closing the health and care gaps. All STPs will need to be underpinned by actionable financial plans, showing how local areas are planning to close their local financial gap over the next five years.
- STPs will become the single application and approval process for being accepted onto programmes with transformational funding from NHS England for 2017/18 onwards. This will help drive coherence between different programmes and tie additional national funding to the successful implementation of STPs.
- NHS England has previously said that the real terms element of growth in CCG allocations for 2017/18 onwards will be contingent upon the development and sign off of a robust STP during 2016/17. Additionally, the most compelling and credible STPs will secure the earliest additional funding from April 2017 onwards, in order to allow them to move further, faster. We are not looking for footprints to develop a bid for funding, but instead to show their credible path to delivery of transformation to 2020/21.