William Eichler 14 November 2016

Councillors should be ‘at the heart’ of designing STPs

Sustainability and Transformation Plans (STPs) are ‘important’ for redesigning local health and care services, but councillors need to be ‘at the heart’ of the planning process, council chiefs say.

Responding to a new report on sustainability and transformation plans from think tank The Kings Fund, the Local Government Association (LGA) has called for councillors and communities to be more involved with developing STPs.

The Kings Fund report said STPs, which are plans for the future of health and care in 44 areas of England, ’offer the best hope to improve health and care services’, but it acknowledged they were ‘beset’ with problems.

The think tank said local government involvement with STPs was ‘patchy’ and there had not been enough time to adequately involve clinicians, frontline staff, patients or the wider public.

They also warned those involved in formulating the transformation plans were ‘struggling with a confused process’ and ‘operating in a sea of fog’.

The King’s Fund pointed to the Health and Social Care Act 2012 as an obstacle to drawing up the STPs. The act had created a complex system and its focus on competition makes it more difficult for organisations to work collaboratively.

Titled Sustainability and Transformation Plans in the NHS, the report warned that due to NHS funding pressures local leaders ‘lack confidence’ in some of the assumptions and projections contained within the STPs.

However, despite these concerns, the think tank urged the Government and the NHS to continue supporting the sustainability and transformation plans - but it made a number of recommendations.

All parts of the health and care system, as well as the public, they advised, should be involved in the plans. Governance should be improved and clarified, and the assumptions contained within the plans should be ‘stress tested’ by the NHS.

Chris Ham, chief executive of The King’s Fund, said: ‘The introduction of STPs has been beset by problems and has been frustrating for many of those involved, but it is vital that we stick with them.

‘For all the difficulties over the last few months, their focus on organisations in each area working together is the right approach for improving care and meeting the needs of an ageing population. It is also clear that our health and care system is under unprecedented pressure, and if STPs do not work then there is no plan B.

’The progress made so far has only happened because of the hard work of local leaders who have been prepared to work around the difficulties. It is vital that NHS national bodies learn the lessons so far, so that we can see STPs fulfil their potential.’

Responding to the report, the chairman of the LGA’s community wellbeing board, Cllr Izzi Seccombe, said: ‘Councils see STPs as an important vehicle for driving the redesign of local health and care services to improve health and wellbeing, keep people out of hospital and improve the quality of care.

‘But we have warned that for STPs to be effective, councillors and communities need to be at the heart of the planning process, not consulted afterwards on pre-determined solutions.’

Cllr Seccombe said the LGA had pushed for the implementation of STPs to be ‘underpinned by local political leadership and with the full engagement of local communities.’

‘Health and wellbeing boards, as the only place where local political, clinical and professional leaders come together, can be pivotal in driving these forward if they are fully involved in the work of STPs,’ she said.

The councillor also warned the plans should recognise the ‘huge financial pressures’ facing social care.

Mr Ham told The MJ (£) there was little evidence that such ‘radical reconfigurations’ would actually achieve the financial savings in the NHS and local government.

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