How did you agree the STP footprints?
The NHS Shared Planning Guidance asked each area to develop a proposed STP footprint by 29 January 2016, engaging with local authorities and other partners on what this should look like. The footprints should be locally defined, based on natural communities, existing working relationships, patient flows and take account of the scale needed to deliver the services, transformation and public health programmes required, along with how they best fit with other footprints.
Will the footprints replace other local NHS governance structures?
No – the local, statutory architecture for health and care remains, as do the existing accountabilities for Chief Executives of provider organisations and Accountable Officers of CCGs. This is about ensuring that organisations are able to work together at scale and across communities to plan for the needs of their population, and help deliver the Five Year Forward View – improving the quality of care, health, and NHS efficiency by 2020/21. Organisations are still accountable for their individual organisational plans, which should form part of the first year of their footprint’s STP.
How do STP footprints fit with other health and care footprints?
The boundaries used for STPs will not cover all planning eventualities. As with the current arrangements for planning and delivery, there are layers of plans which sit above and below STPs, with shared links and dependencies. For example, neighbouring STP areas will need to work together when planning specialised or ambulance services or working with multiple local government authorities and, for areas within a proposed devolution footprint that cross STP boundaries, further discussion will be required in working through the implications. Other issues will be best planned at Clinical Commissioning Group (CCG) level.
How will other partners be involved?
STPs will need to be developed with, and based upon, the needs of local patients and communities and command the support of clinicians, staff and wider partners such as local government. We cannot transform health and health care without the active engagement of the clinicians and staff who actually deliver it, nor can we develop care integrated around the needs of patients and users without understanding what our communities want and without our partners in local government. That is why we are asking for robust local plans for engagement as part of the STP process. Where relevant, areas should build on existing engagement through Health and Wellbeing Boards and other existing local arrangements.
What does success look like?
If we get this right, together we will engage patients, staff and communities from the start, allowing us to develop services that reflect the needs of patients and improve outcomes by 2020/21, closing all three gaps. We will mobilise energy and enthusiasm around place-based systems of health and care, develop the ownership, relationships and governance necessary to deliver, providing a coherent platform for future investment from the Sustainability and Transformation Fund.
This will require a different type of planning process – one that releases energy and ambition and builds greater trust ownership. It will require the NHS at both local and national level to work in partnership across organisational boundaries and sectors, and will require changes not just in process, but in culture and behaviour.
What role does local government play?
The NHS shared planning guidance, published in December 2015, explained that the success of STPs will depend on having an open, engaging, and iterative process that harnesses the energies of clinicians, patients, carers, citizens, and local community partners including the independent and voluntary sectors, and local government through health and wellbeing boards. A number of STP footprints are being led by local government leaders.