What are the implications of the NHS’s ‘STPs’?

NHS Sustainability & Transformation Plans (STPs) have finally hit the headlines (BBC News; The GuardianI News). Up until a few weeks ago they seemed to be almost unheard of.

STPs were first announced by NHS England in a December 2015 report called Delivering the Forward View: NHS planning guidance 2016/17 – 2020/21. This called on “local health systems,  including clinicians, patients, carers, citizens, and local community partners including the independent and voluntary sectors, and local government through health and wellbeing boards, to work together to develop robust plans to transform the way that health and care is planned and delivered for their populations”. Draft STPs are required by mid-September 2016.

Local health ‘systems’ first of all had to identify the ‘footprint’ they would adopt for their STP. There are now 44 STP ‘footprints’ across the country. But these seem to be reinventing the catchment areas — the populations — served by groups of NHS organisations. Birmingham’s STP ‘footprint’, for instance, which is led by Mark Rogers, chief executive of Birmingham City Council, includes the acute trusts, community health trust, mental health trust, the local authority, and three Clinical Commissioning Groups (CCGs) — Cross City, South Birmingham, and Solihull. But it doesn’t include Sandwell and West Birmingham CCG because this falls into the Black Country ‘footprint’.

On one level, of course, STPs make perfect sense. They could help ensure that health provision is designed for entire localities rather than individual organisations; they could help better integrate health and social care; they could be integral to the NHS delivering its Five Year Forward View. But awareness of the STPs is poor and so far there seems to have been little effective community consultation or engagement. Whether the draft STPs mark the beginning or the end of a process is also far from clear.

Social enterprises and the wider third sector need to be doing much more to better understand STPs — and how they get involved in them. We certainly plan to do what we can to aid this process — but if you are already involved somehow in the process, now is the time to be sharing what you know and what you have learnt. This is a key opportunity to ensure that the voice of community users and providers is heard loud and clear in the STP process, and to ensure that social value (the Public Services [Social Value] Act 2012) — which health has done relatively little to capitalise on so far — is fully embedded in these plans.

You can find out more about the STPs on the NHS England website:

Overview and explanation.

 Explanation of ‘footprint’ areas.

 Map of ‘footprints’.

STP ‘footprint’ leaders.

An interesting paper by health academic Colin Leys analysing STPs published by the Centre for Health & the Public Interest.

Birmingham UK. Freelance research, evaluation and policy consultant specialising in social enterprise and the third sector. I maintain the BSSEC blog and website

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