Frequently asked questions – STPs

What is an STP?

STP stands for Sustainability and Transformation Plan. These are local plans that aim to improve health and care.

Produced collaboratively by local NHS organisations and local councils, they set out practical ways for the local NHS to improve NHS services and health outcomes for people in every part of England.

They aim to help meet a ‘triple challenge’ set out in the NHS Five Year Forward View – better health, transformed quality of care delivery, and sustainable finances.

Who drew up the proposals?

STPs are the NHS’ own proposals to improve services for patients. They are being built in partnership with democratically elected local councils and in discussion with the communities they serve.

A collaborative approach has allowed local leaders to plan around the needs of whole areas, not just those of individual organisations.

Plans are arranged across 44 geographical areas (or ‘footprints) which cover the whole of England. 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 (CCGs), local government senior leaders and clinicians.

Each area is responsible for agreeing what area and leadership model work best locally.

What is the status of STP proposals?

Proposals have been published for every part of England.

STPs evolved during last year and will continue to do so as each local area discusses the thinking with staff, patients and other local people. These conversations are still taking place and STPs will continue to reflect them.

What do the proposals mean for patients?

The proposals include common-sense changes to improve patients’ lives. These include things  that patients often tells the NHS they care about; like making it easier to see a GP, speeding up cancer diagnosis and offering help faster to people with mental ill-health.

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

What about NHS frontline staff?

The proposals are based on local knowledge about the priorities and challenges in different parts of the country. Frontline staff are crucial to understanding these. Many STP leadership teams include clinical representatives and several footprint leaders come from a clinical background.

STPs have allowed areas to think about long-term solutions to local workforce challenges, as well as supporting staff to develop their skills and provide the best care possible for patients.

What will happen next?

In 2016 each area began to discuss their proposals with local staff and communities.

All proposals are published and every STP needs to intensify this engagement – the involvement of clinicians will be crucial. Where possible, they will draw on networks established by medical royal colleges, trade unions, the voluntary and community sector, and others.

NHS England, NHS Improvement and other national bodies will take further steps to strengthen collaboration around STPs in 2017, including:

  • Reviewing STP requests for extra capital funding, and deciding which ones can be funded;
  • Encouraging STPs to learn from each other;
  • Investing a growing share of national resources into implementing STPs and related national change programmes.

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.

Will STPs replace ‘new care models’?

STPs do not replace new care models. They provide a partnership system of leadership and oversight in every part of the country which will allow new care models to evolve and spread.

From April 2017, STPs will become the single application and approval point for local organisations to access NHS transformation funding. One of the original aims of STPs was to develop new care models, blueprints for future care introduced initially under the ‘vanguard’ and ‘pioneer’ programmes.

What will happen to STPs in future years?

STPs were never designed to answer every question facing health and care services. But they have been important in getting the right groups of people to think about what fundamental changes are needed locally.

Ultimately, the NHS must turn STPs into delivery partnerships focused on implementing the proposals. Most will be forums for shared decision-making, supplementing the role of individual boards and organisations.

A small number of STP partnerships may evolve into integrated or ‘accountable’ care systems. In these areas, providers and commissioners could come together, with a combined budget and fully shared resources, to serve a defined population.