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Delivering sustainability and transformation plans

From ambitious proposals to credible plans

This report examines the content of the 44 sustainability and transformation plans (STPs) that were submitted in October 2016. STPs are the main vehicle for transforming health and care services in England in line with the NHS five year forward view.

The report discusses the main challenges that lie ahead in implementing STPs and realising the opportunities they identify.

Key findings

  • STPs offer the best hope for the NHS and its partners to sustain services and transform the delivery of health and care.

  • STPs are wide-reaching and propose changes in a number of areas – from prevention through to acute and specialised services.

  • A high priority for many STPs is to redesign services in the community to moderate demand for hospital care.

  • Proposals to reconfigure hospitals could improve quality but need to be closely scrutinised and considered on their merits.

  • Proposals to reduce capacity in hospitals will only be credible if there are robust plans to provide alternatives in the community.

  • Cuts in social care and public health and a lack of earmarked funds to support transformation will affect the ability of NHS organisations and their partners to implement STPs.

Policy implications

  • The proposals in STPs now need to be developed into credible plans, with clarity about the most important priorities in each footprint.

  • The NHS should engage meaningfully with staff, patients and the public, local authorities and the third sector in discussing the proposals.

  • The governance and leadership of STPs needs to be strengthened and more realistic timescales adopted for implementation, given the time it takes for innovations in care to become established and deliver results.

  • National bodies should work together to support the NHS and local authorities to implement the plans and send out consistent messages on what they now expect.

  • The government should reiterate its commitment to STPs and support their proposals where the case for change has been made. It should recognise the need for additional resources for the NHS and social care if the STPs are to deliver the proposed transformations in care.

  • Changes to the law are needed to amend aspects of the Health and Social Care Act 2012 that are not aligned with the Forward View, particularly in relation to market regulation.