Sustainability and Transformation Plan (STP)
September 2016
In December 2015, the NHS shared planning guidance 2016/17 – 2020/21 outlined a new approach to help ensure that health and care services are built around the needs of local populations. To do this, every health and care system in England will produce a multi-year Sustainability and Transformation Plan (STP), showing how local services will evolve and become sustainable over the next five years – ultimately delivering the Five Year Forward View vision of better health, better patient care and improved NHS efficiency.
Sustainability and Transformation Plans (STPs) are seen as the key mechanism for implementing the NHS Five Year Forward View(FYFV) and its vision of better health and wellbeing, improved quality of care, and a sustainable and efficient NHS.
The introduction of the STP process is an ambitious attempt to impose financial discipline and at the same time drive innovation and transformation across the NHS in England. The intention is that the plans produced by the 44 STP footprint areas across England and agreed with NHS England and NHS Improvement will be the driving force for local health planning and delivery, at least for the next two years.
What are they?
STPs will be place-based (across 44 Footprint areas – see below) multi-year plans built around the needs of local populations. The emphasis is placed on planning for local populations rather than individual institutions (such as a single hospital trust or sole provider). STPs are expected to help drive a genuine and sustainable transformation in health and care outcomes between October 2016 and March 2021. They are also intended to help build and strengthen local relationships, enabling a shared understanding of where things stand and a shared ambition for 2021 and the concrete steps needed to get there.
A wide range of stakeholders (commissioners, providers, local authorities) will come together to create this local plan or ‘blueprint’ describing how each area will work together to close three nationally identified gaps:
• The health and wellbeing gap
• The care and quality gap
• The finance and efficiency gap
With respect to specific diseases or health issues, each of the 44 STP footprints were instructed to ensure their plan outlines their approach to: cancer, diabetes, learning disabilities, maternity, mental health and dementia.
Access to a £1.8 billion Sustainability and Transformation Fund (STF) was promised to the best plans. However, the third identified gap – addressing funding and efficiency challenges – is the core imperative for the STP process and therefore the key focus of plans has been on financial control.
This message has been reinforced by NHS leaders. Both Simon Stevens and Jim Mackey, Chief Executives of NHS England and NHS Improvement respectively, have stated that the STPs are ‘not a bidding process’, but a decision-making process. Both have stressed the need to use the opportunity of the development of STPs to tackle the difficult decisions or longstanding ‘elephants in the room.’ The expectation is that this will be achieved through new approaches rather than additional resources.
This means that those developing the plans have had to attempt to balance two different core elements – sustainability and financial control on the one hand, and major system reform and transformation on the other.
The majority of ‘final’ STPs are now expected to be submitted by October 2016. However, it remains unlikely that all footprint areas will comply with this deadline, or will submit plans that meet NHS England’s expectations. The final plans submitted in October will form the basis for two-year, organisation level operating plans for 2017/18 and 2018/19.
To deliver plans that are based on the needs of local populations, local health and care systems came together in January 2016 to form 44 STP ‘footprints’. The health and care organisations within these geographic footprints are working together to develop STPs which will help drive genuine and sustainable transformation in patient experience and health outcomes of the longer-term.
The footprints should be locally defined, based on natural communities, existing working relationships, patient flows and take account of the scale needed to deliver the services, transformation and public health programmes required, along with how they best fit with other footprints.
Sustainability and Transformation Plan (STP)leadershave now been agreed in the majority of areas. These senior figures have agreed to convene the STP process and to oversee the development of local plans. They have been selected following local discussions about who is best placed to playtogether with discussions with national bodies.
STPs footprints are not statutory bodies, but collective discussion forums which aim to bring together health and care leaders to support the delivery of improved health and care based on the needs of local populations. They do not replace existing local bodies, or change local accountabilities.
STPs will be submitted in June, with a view to implementation starting in Autumn 2016.
The partners
STPs are a key element on the NHS Shared Planning Guidance and the local implementation of the Five Year Forward View.
They are supported by six of the national health and care bodies:
NHS England, NHS Improvement, the Care Quality Commission (CQC), Health Education England (HEE), Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE).
Contacts in the North- Footprint and Footprint Lead
Northumberland Tyne and Wear
Mark Adams (Chief Officer, Newcastle and Gateshead CCG)
email: . Telephone on 0191 217 2996
Durham (Includes Durham Dales, Easington & Sedgfield CCG area) Darlington and Tees, Hambleton, Richmondshire and Whitby.
Alan Foster (Chief Executive, North Tees and Hartlepool NHS Foundation Trust)
email:
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