Frequently asked questions – STPs

What is an STP?

STP stands for sustainability and transformation partnership. These are areas covering all of England, where local NHS organisations and councils drew up shared proposals to improve health and care in the areas they serve.

STPs were created to bring local health and care leaders together to plan around the long-term needs of local communities. They have been making simple, practical improvements like making it easier to see a GP, speeding up cancer diagnosis and offering help faster to people with mental ill health.

In some area, STPs have evolved to become ‘integrated care systems’, a new form of even closer collaboration between the NHS and local councils. The NHS Long Term Plan set out the aim that every part of England will be covered by an integrated care system by 2021, replacing STPs but building on their good work to date.

What is an integrated care system?

An integrated care system is an even closer collaboration with NHS organisations, in partnership with local councils and others, taking collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve.

Local services can provide better and more joined-up care when different organisations work together in this way. For staff, improved collaboration can help to make it easier to work with colleagues from other organisations. And systems can better understand data about local people’s health, allowing them to provide care that is tailored to individual needs.

Why are STPs and integrated care systems needed?

STPs and integrated care systems are a way for NHS organisations and councils to develop their own, locally appropriate proposals to improve health and care for residents. They work in partnership with democratically elected local councils, drawing on the expertise of frontline staff and on conversations about priorities within the communities they serve.

This collaborative approach has allowed local leaders across the country to plan around the needs of whole areas, not just those of individual organisations. They are led by well-respected figures from different parts of the NHS and local government, including chief executives of NHS trusts, accountable officers of clinical commissioning groups, local government senior leaders and clinicians.

Working together they are in a better position to deliver the NHS Long Term Plan’s aim for ‘triple integration’ of primary and specialist care, physical and mental health services, and health with social care.

What does an integrated care system mean for people who use services?

Much like the work undertaken by STPs, integrated care systems will look to deliver practical changes to improve peoples’ lives. With a range of organisations and frontline professionals working together more closely, patients are seeing services work in a more joined up way, are only having to tell their story once and are receiving care better tailored to their individual needs.

The NHS is one of this country’s proudest achievements and it has always adapted to improve care. The growing number of older people in England is in part a testament to its success. But, with demand for care rising and new technologies emerging, the NHS needs once more to adapt to a changing world.

To achieve this, the NHS Long Term Plan set out a renewed focus on joining up services and investing in ways to prevent illness and keep people out of hospital. Integrated care systems are the central way that local family doctors, hospitals, care homes and others will do this.

What about frontline staff?

STPs and integrated care systems draw on local knowledge about the priorities and challenges in different parts of the country. Frontline staff are crucial to understanding these. Many senior leaders come from a clinical background and leadership teams often include clinical representatives.

STPs and integrated care systems allow areas to think about long-term solutions to local workforce goals and challenges, as well as supporting staff to develop their skills and provide the best care possible.

Have communities been involved in the development of STPs and integrated care systems?

Yes. In establishing STPs proposals were discussed with local staff and communities. These proposals were published in 2016 and STPs, with the involvement of clinicians, engaged with networks established by medical royal colleges, trade unions, the voluntary and community sector, and others.

Engagement is ongoing within local communities as STPs are replaced by integrated care systems, with clinical guidance also assured as the NHS Long Term Plan sets out the need for engagement with primary care, including through a named accountable Clinical Director of each primary care network.

A partnership board will also be established, drawn from and representing commissioners, trusts, primary care networks, and – with the clear expectation that they will wish to participate – local authorities, the voluntary and community sector and other partners.

As we move from STPs to integrated care systems, no changes to the services people currently receive will be made without local engagement and, where required, formal public consultation. There are longstanding assurance processes in place to make sure this happens.

How can the success of an integrated care system be measured?

Performance measures will include a new ‘integration index’ developed jointly with patient groups and the voluntary sector which will measure from patient’s, carer’s and the public’s point of view, the extent to which the local health service and its partners are genuinely providing joined up, personalised and anticipatory care.

Will STPs and integrated care systems replace ‘new care models’?

One of the original aims of STPs was to develop new care models, blueprints for future care introduced initially in what were called ‘vanguard’ and ‘pioneer’ areas. STPs and integrated care systems do not replace new care models; rather, they are allowing more parts of England to build on their success, by providing a collaborative system of leadership and governance in which new ways of providing care will evolve and spread.

What’s next for integrated care?

The NHS Long Term Plan requires every STP to become an integrated care system by April 2021. To aid this process local health systems will have access to expert advice and support through the regions including clinically focused transformation and access to technical expertise in a range of business issues such procurement, estates and corporate services.

Residents will be able to see practical day-to-day benefits as their local health and care system works to provide more seamless services, using improved understanding of data to deliver care better tailored to people’s individual needs. Communities will also see further moves to help avoid unnecessary trips to hospital and to support them in living healthier day-to-day lives.