Sustainability and Transformation Plans
How serious are the proposals?
A critical review
Seán Boyle, John Lister, and Roger Steer
In late 2016, 44 geographical areas of England published Sustainability and Transformation Plans setting out how health and care will be delivered within their local areas by 2021, to achieve the aims of the Five Year Forward View, to restore and maintain financial balance, and to deliver core access and quality standards for patients. This report is not a commentary on whether there should be STPs but on how they are set up to deliver the level, pace and scale of change required.
This report critically reviews each of the 44 STPs in terms of how they stand as serious, coherent and achievable plans. Each was subject to the levels of rigorous appraisal you would expect for ant set of NHS planning documents. The researchers were looking for clear expert evidence, how the plans matched population needs, the resources required, the key assumptions in the overall approach, and how local accountability operates across the footprint. Overall the report finds that the STPs are not ready for implementation, with the plans lacking a secure grounding in the current situation, and a robust evidence base to the changes proposed. Significant developments in the relationship between the NHS and Local Government are required and this will take time. The emphasis on reducing acute beds and A&E attendance will require local consultation. Legislative change is also required to free health and care from the constraints of the market to provide integrated quality care for local populations. Finally there is a significant funding shortfall, and a need for clear and robust workforce plans.