Plans to overhaul health care at the local level have resulted in many ‘business as usual’ propositions rather than the transformational ideas needed, report says.

The Chartered Institute of Public Finance and Accountancy (CIPFA) has assessed the 44 draft Sustainability and Transformation Plans (STPs) that have been put together by the NHS and local authorities.

STPs are designed to make improvements to health and social care at the local level, and improve the financial sustainability of the health care sector which, CIPFA estimates, faces a £10bn funding gap by 2020/21.

CIPFA’s analysis found that the plans represent a positive, place-based step forward. However, it warned the timescales and speed of savings required have led to a number of ‘business as usual’ propositions, rather than the development of the concrete, transformational changes needed to deliver financial sustainability in the long term.

It called for adequate upfront investment; robust governance arrangements; and thorough contingency planning, with realistic assessments of alternative scenarios.

‘Service integration is a no-brainer for patients, families and stretched NHS teams and as a means of addressing the need for financial stability in the health sector, STPs offer a promising start towards taking forward the changes needed in the health and social care system,’ said Rob Whiteman, CIPFA chief executive.

‘In reviewing the 44 plans, it is clear that much still needs to be done, particularly in developing full scenario planning and understanding risk. Transparency and realism is crucial, even if it does expose the difficulties involved in achieving the plans.

‘Otherwise there is a danger that the desire to present a positive position will lead to unrealistic judgements being made.

‘To this end, CIPFA is keen to support finance leaders, from both the NHS and local government, involved the preparation of STPs so that they feel able to represent a realistic assessment of the financial position.’

Meanwhile, Labour have called STPs ‘chaotic’ and said they would halt them if elected.