Frequently asked questions – STPs

What is an STP?

STP stands for sustainability and transformation partnership. These are 44 areas covering all of England, where local NHS organisations and councils have drawn up proposals to improve health and care in the areas they serve.

STP can also stand for ‘sustainability and transformation plan’, plans drawn up in each of these areas setting out practical ways to improve NHS services and population health 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 a way for the NHS to develop its own, locally appropriate proposals to improve health and care for patients. They are working in partnership with democratically elected local councils, drawing on the expertise of frontline NHS staff and on conversations about priorities 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.

The partnerships 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.

What is the status of STP proposals?

Proposals have been published for every part of England. A small number of the partnerships are now evolving into integrated or ‘accountable’ care systems (ACSs). In these areas, providers and commissioners come together, with a combined budget and fully shared resources, to serve a defined population.

STPs are a work in progress – they have evolved since organisations began working together in 2016, and will continue to do so as every area holds conversations with local staff, patients and the public. These conversations are still taking place and local proposals will continue to reflect them.

What do the proposals mean for patients?

The proposals include practical 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 senior leaders come from a clinical background and leadership teams often include clinical representatives.

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 STP area began to discuss its proposals with local staff and communities.

Since all proposals were published in 2017, STPs have begun to intensify this engagement – the involvement of clinicians is a crucial part of this. Where possible, they are drawing 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’?

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. STPs do not replace new care models; instead they will allow more parts of England to build on their success, by  providing a collaborative system of leadership and governance in every part of the country which will allow new care models to evolve and spread.

In April 2017, STPs became the single application and approval point for local organisations to access NHS transformation funding.

What will happen to STPs in future years?

Sustainability and transformation partnerships were not designed to answer every question facing health and care services. But they are bringing together the right groups of people to think about what fundamental local changes are needed in every part of England.

Partnerships will be forums for shared decision making, supplementing the role of individual boards and organisations. Their immediate focus will be on refining and implementing the 44 sustainability and transformation plans so that patients can see practical benefits in their local health system.Other areas may wish to become ‘accountable care systems’, in which those who provide services and those who pay for them come together with a combined budget and fully shared resources to serve a defined population.