Health and care bodies reveal the map that will transform healthcare in England

National health and care bodies in England have published details of the 44 ‘footprint’ areas that will bring local health and care leaders, organisations and communities together to develop local blueprints for improved health, care and finances over the next five years, delivering the NHS Five Year Forward View.

Senior leaders who will be leading this work have also been confirmed today, with broadly equal representation from clinical commissioning groups and from hospitals and other providers of care, as well as some key figures from local authorities, recognising the need for local systems to work in partnership. They include:

  • Dr Amanda Doyle OBE, GP, Chief Clinical Officer of NHS Blackpool Clinical Commissioning Group and Co-Chair of NHS Clinical Commissioners (Lancashire and South Cumbria footprint);
  • Sir Andrew Morris, Chief Executive of Frimley Health NHS Foundation Trust (Frimley Health footprint);
  • Angela Pedder OBE, Chief Executive of the Royal Devon & Exeter NHS Foundation Trust (Devon footprint);
  • David Sloman, Chief Executive of the Royal Free London NHS Foundation Trust (North Central London footprint);
  • David Smith, Chief Executive of NHS Oxfordshire Clinical Commissioning Group (Buckinghamshire, Oxfordshire and Berkshire West footprint);
  • Sir Howard Bernstein, Chief Executive of Manchester City Council (Greater Manchester footprint);
  • Mark Rogers, Chief Executive of Birmingham City Council and President of the Society of Local Authority Chief Executives (Birmingham and Solihull footprint); and
  • Toby Sanders, Accountable Officer of NHS West Leicestershire Clinical Commissioning Group (Leicester, Leicestershire and Rutland footprint).

Last December, NHS shared planning guidance set out a new approach to help ensure that health and care services are planned by place rather than solely around individual institutions, over a period of five years, rather than just a single year. Central to this are the design and delivery of Sustainability and Transformation Plans (STPs), which must show clearly how each area will pursue the ‘triple aim’ set out in the NHS Five Year Forward View – improved health and wellbeing, transformed quality of care delivery, and sustainable finances.

Frontline leaders have worked together closely to agree the most locally appropriate boundaries, recognising that footprints will not cover all planning eventualities, and that different areas will have different needs. Populations range from 300,000 (in West, North and East Cumbria) to nearly three million people (in Greater Manchester). They include five local areas within London, and many which are in line with county boundaries.

NHS England worked to establish a Sustainability and Transformation Fund of £2.1bn for 2016/17, which will rise to £2.9bn in 2017/18 and to £3.4bn in 2020/21. STPs will become the single application and approval process for being accepted onto programmes with transformation funding from 2017/18 onwards.

Most of the 44 areas will be led by people already working in the local health and care economies, with named individuals responsible for convening, overseeing and coordinating their STP work. They are individuals who command both local and national support, whose collective efforts alongside colleagues will help transform health and care over the next few years.

The national bodies are also publishing guidance and templates to support areas in submitting information about their governance and priorities by 15 April, in advance of final submissions by the end of June.

Simon Stevens, Chief Executive of NHS England, said: “Now is quite obviously the time to confront – not duck – the big local choices needed to improve health and care across England over the next five years, and STPs are a way of doing this. Their success will largely depend on the extent to which local leaders and communities now come together to tackle deep-seated and long-standing challenges that require shared cross-organisational action. The NHS nationally will be working closely to support them in doing that.”

Jim Mackey, Chief Executive Designate of NHS Improvement, said: “Everyone accepts that change is needed within the NHS. We need to create a health and care system that meets the needs of patients and is sustainable for the long-term.

“Improvement within the NHS needs organisations to work strategically within their local health economy. We need the Sustainability and Transformation Plans to encourage organisations to work together, to think boldly and to work out how change – no matter how radical – can best be achieved to meet the major challenges we face.

“NHS Improvement will continue to support these local areas as they look to deliver the improvements we all want to see.”

Duncan Selbie, Chief Executive of Public Health England said: “Place-based planning is at the heart of making this happen – leaders from local government and the local NHS working together to close the three gaps and squeezing the best possible value from their shared work.

“Some footprints cross multiple localities and we are sensitive to the need for STPs to align local plans with the work on devolution agreements and PHE is ready to support this every step of the way.”

Dr Amanda Doyle, leader for Lancashire and South Cumbria footprint, said: “I am very pleased to be working with my colleagues across the Lancashire and South Cumbria STP footprint as we draw up our plans to make sure that health services in our area rise to the challenges set out in the Five Year Forward View.

“I am very conscious that my role is only one of many that will be needed if we are to secure sustainable services and I don’t underestimate the task that we have ahead of us. I am looking forward to the opportunity to see how other areas are tackling the same sorts of issues that we face – I am sure that there is much that we can learn from one another.”

David Sloman, leader for North Central London footprint, said: “I’m really looking forward to working with our partners in North Central London to improve the health of the communities we serve.”

Mark Rogers, leader for Birmingham and Solihull footprint, said: “I am pleased that through a natural consensus, my council and NHS colleagues across Solihull and Birmingham have shown faith and confidence in me to take and develop a system leadership role across our shared places. This will give me the opportunity to see if we can make some pretty seismic changes to the way we address the needs of local people at a time when quality, service models and finances are all under immense pressure. I look forward to working collaboratively with the many organisations who can – and must – act together and in harmony to improve our citizens’ lives.”


  1. Tom Donnelly says:

    The tenor of the proposals seems to be a cost cutting exercise . What is required is a major investment of resources in community based services to improve the quality of life . Public health investment . Trying to pretend that 5 day resources can be stretched to cover 7 days does not encourage a belief that STP planning will fare better . A programme of health education backed by quality of life investments is needed

  2. Stacey English says:

    Is it possible (does it exist yet!) to get an org table for each STP please?

  3. Pam Hurley says:

    So, nobody looking after Hertfordshire in this exercise, but looking after Frimley and Surrey with half the population very well indeed. Hertfordshire is a huge area and greatly increased by the addition of West Essex. What’s the logic when Frimley and Surrey at half the population cover VERY much smaller areas Reasons for the strange divisions, please.

  4. DC says:

    There are so many quangos working within the structure of the NHS and getting good money for it. For example CCGs STPs SPTs to name a few.
    What the NHS needs is a less complicated structure where large sums are not spent on ‘consultants’ and ‘consultants of consultants’ and each Trust spending effort on tendering for other trusts work.
    An area should have 1 trust, that should encumber all services and managed accordingly. They should report to one body who in turn should report to government.

  5. L P says:

    Would it be possible (or does it already exist) to get an Excel list of each CCG and which STP they are in to use as a lookup table?


  6. Algar Goredema-Braid says:

    A useful step forward – please engage frontline staff and the people we serve. The challenge remains in not doing to but doing with.

  7. Miss Valerie Evans says:

    Why is no one speaking for SW London,facing bankruptcy locally? In London only N London is mentioned as a footprint leader. Seems as we feel locally no leadership here we are all financially down the drain!

  8. peter Coleing says:

    I have grave doubts that we will see any real change, Just more cutting of services were people need them. Transformation will again be used to cover the cuts to services and saving money. Transformation and change management is about cutting out waste and making processes more efficient! Older people need to access services in places where they can get to easy travel is not easy for many.

  9. Pete says:

    Makes complete sense collaborating in this way, which of course saves money. Maybe this won’t be the sole reason for looking at things in this way? I doubt this somehow.

  10. Jon Ward says:

    Splitting Cumbria into two footprints seems to be complete lunacy. It sends a particularly unhelpful message to those who live in the most troubled area for healthcare in this county – the junction between the two footprints (particularly southern Copeland). Here you will find very poor equality of access to acute hospital services, diminishing GP services and a general feeling that the NHS does not care about anything south of a variable boundary that is probably north of Whitehaven. Even if you are simply looking to win the PR battle, this decision has to be questioned.

  11. Nye says:

    After the shall we say problems at Addenbrooke, Hichingbrooke, Beacher’s Brooke Stafford there seems to be a delay in these footprint areas. What did Simon Stevens say to Monitor about the delay ?

  12. David Peach says:

    Health and High Quality Care for all, now and for future Generations. That applies for the NHS before the Conservatives started cherry picking. The now is untrue.
    The Future is questionable.