Sustainability and transformation plans in the NHS

Sustainability and transformation plans in the NHS: How are they being developed in practice, 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.

Despite the importance of STPs for the NHS and the public, little is known about the process of developing the plans and how the initiative has worked in practice. Based on a series of interviews with senior NHS and local government leaders which took place throughout 2016, this report looks at how STPs have been developed in four parts of the country.

 

Key findings of the report are:

  • Local context and the history of collaboration within STP footprints have played a major role in determining the progress of the plans.
  • Despite the focus on local ownership, key elements of the process have been ‘top-down’.
  • National requirements and deadlines for the plans have changed over time, and guidance for STP leaders has sometimes been inconsistent and often arrived late.
  • The approaches of national NHS bodies and their regional teams have not always been aligned.
  • Tight deadlines have made it difficult to secure meaningful involvement in the plans from key stakeholders, including patients and the public, local authorities, clinicians and other frontline staff.
  • Organisations face fundamental policy barriers to working together on STPs; existing accountability arrangements focus on individual rather than collective performance.
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