The types of service changes and structural reform that will dominate sustainability and transformation plans are revealed in HSJ’s survey of senior local NHS decision makers.

There were 99 responses to the survey of clinical commissioning group chairs and accountable officers – the groups’ two most senior leaders – representing about 47 per cent of the total 209 CCGs.

The CCG barometer, supported by PA Consulting Group, was carried out between late September and yesterday. It found:

  • The most widespread service change priorities are to strengthen prevention and out of hospital services, and sharing more records and data.
  • Downgrading or closing community hospitals and centralising provider back office both feature in a majority of respondents’ STPs.
  • Substantial minorities say their plans include likely more controversial moves such as closing or downgrading a full accident and emergency unit.
  • Less than 15 per cent believe substantial commissioning functions will be passed to providers in the next 12-18 months, supporting the view that widespread moves to substantive accountable care organisation type models will not happen quickly.
  • More than two-thirds cite lack of capital funding, lack of revenue funding and lack of change capacity/capability as significant barriers to STP delivery.
  • Sixty per cent cite political opposition as a significant barrier and 61 per cent cite organisational priorities trumping whole system plans.

All 44 STPs were required to submit “full” current plans last Friday. Only two have so far published their submissions. More are expected to do so in coming weeks, but many STP leaders have been told by national officials not to publish details until they have been checked nationally.

The remainder of this article shows the full survey findings about STPs.

Service changes

What changes are taking place or are likely in the next 12-18 months, as part of the STP process and implementation, to the services provided in your STP area? CCG leaders were asked to choose from a list of potential changes, with the option of specifying “others”.

Other changes identified by respondents included “full integration of health and social care”, “focus on developing sustainable communities”, “reduction in treatment thresholds, more access restrictions”, “increase in public health education and self care”, and “GP practice consolidation or joint working”.

System changes

What changes are taking place or are likely in the next 12-18 months, as part of the STP process and implementation, to the way services are commissioned, run, led and funded in your STP area? CCG leaders were asked to choose from a list of potential changes, with the option of specifying “others”.

Other changes identified by respondents included “pursuing devolution”, “iImplementation of STP subdivisions” and “merger of CCGs”.

Barriers to change

Identify likely significant barriers to the success of your STP. CCG leaders were asked to choose from a list of potential barriers, with the option of specifying “others”.

 

Exclusive: Survey reveals STPs' service change priorities