Sustainability and transformation plans (STPs) still have potential to improve health and care services in England despite a bumpy start, argues the King’s Fund in a new report on the scheme. 

Delivering sustainability and transformation plans: From ambitious proposals to credible plans provides a descriptive overview of the draft plans that were submitted last October and assesses both the opportunities they represent and the difficulties in implementing them.

The key findings of the report include:

  • STPs remain the best hope for the NHS and its partners despite a difficult start
  • Stronger governance and closer engagement with NHS staff, patients and the public, local authorities and others is needed to develop the plans
  • While STPs can help move care closer to home and moderate demand for hospital services, proposals to reduce the number of hospital beds are not credible without first investing in community services
  • Political support will be crucial to implementing the plans.

Five Year Forward View

STPs were conceived as a way of achieving NHS Five Year Forward View objectives at a local level and to address health inequalities in the populations they serve. They bring NHS organisations together with local authorities and other partners to agree the future direction of health and care services in 44 areas of England.

The report shows that the draft plans that have been submitted are wide-ranging, from prevention and community-based services through to acute and specialised services in hospitals.

The King’s Fund says that STPs have been submitted at a time when financial and operational performance is much more strained then in October 2014, when the Five Year Forward View was launched. There are a number of challenges to implementing the plans, including limited funds for care in the community, coming up with a realistic timescale for implementation and creating capacity to build on the foundations that have already been laid down. 

'Best hope for the NHS'

King’s Fund chief executive Chris Ham says in a blog post discussing the report: “Notwithstanding these concerns, we believe that STPs offer the best hope for the NHS and its partners to sustain and transform the delivery of health and care services. 

"The challenge now is to translate the ambitious proposals contained in the drafts into credible plans, with clarity about the most important priorities in each area.”

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