Survindar Chahal FPM Content Manager

The Most Important Things You Need to Know About STPs

One of the key outcomes of NHS England’s Five Year Forward View was the move to create 44 Sustainability and Transformation Plans (STPs) to help deliver healthcare reform. The plans have become a source of controversy in the news and will finally be formally introduced this month, so we have broken down exactly what they are and how they will affect general practice.

NHS England describes the STP plans as a way of “making common-sense changes to how the NHS works” - a collaboration between healthcare organisations that will give GP practices, doctors, nurses and other care staff the best chance of success.

STPs are partnerships between healthcare teams and local councils working together to develop plans and proposals to make improvements to the delivery of health services, all of which are tailored to the needs of the local population. 

They are led by a variety of figures from the NHS and local councils, including chief executives of NHS Trusts, CCG accountable officers and senior local government leaders. In November last year we interviewed former Health Secretary Stephen Dorrell about his role as independent chair of the Birmingham & Solihull STP Board, which provided some very interesting insights into the process.

The original purpose of STPs was to support local areas in improving the quality of care they provide and finding ways to make it more efficient, investigating the benefits of new models of care and emphasising preventative care to reduce the demand on health services. Over time, those priorities shifted to focus on how STPs can balance the NHS books.

From a financial point of view, there’s no hiding that one of the STPs’ key priorities was to look at how the NHS can operate with the predicted £22bn budget deficit by 2020, with an expectation that they will identify savings and increase efficiencies while delivering a safe service. In real terms, and by looking at some of the proposals already made, this will mean a reduction in services – fewer beds, fewer A & E departments, and services that their reports have said are “unnecessary”.

In September 2016 most of the media coverage focused on NHS services and beds being lost, services being centralised or shut down. STPs have also been tasked with reducing staffing costs, NHS estates and surplus land costs, as well as consolidating back office roles and tasks.

Many STPs are using primary and acute care services - as well as the new multispecialty community providers (MCPs) - as an unofficial template for how services will be locally delivered. That means we could see 44 distinctly different and devolved health and social care systems.

NHS England maintains that STPs will set out plans to strengthen primary care in line with the GP Forward View, setting out new ways for general practices to deliver services on their own and integrating with hospital care, including new ideas like primary care hubs, ‘super practices’ and exploring new models of care.

General Practice may end up either benefiting from these changes, or may well be a part of them. A more localised emphasis could help cut costs and referrals, introducing new funding routes that weren’t available before. However, a report by the King’s Fund identified that because of the tight timescales in setting up the STPs, there was little engagement with GPs, primary care staff and clinicians. This is a surprising revelation when they will be the ones delivering the services to the end users – patients.

How do you feel about the roll-out of STPs? Do you think they will be successful in helping healthcare providers work closer together? Stay tuned to the FPM Blog for a look at what STPs mean for transformation funds next week.


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