NHS organisations in a “significant number of STPs… are still squabbling about last year’s invoices”, one of the NHS’s most senior national directors has said.

Speaking at Health+Care Show in London on Wednesday, NHS England’s national director of operations and information said not all sustainability and transformation partnership were embracing good system working.

“There are significant number of STPs that are still squabbling about last year’s invoices…we need to be bigger than that,” said Mr Swindells.

He called on NHS leaders to to “park their egos at the door” and stop conflict over funding and territory.

Mr Swindells has recently been given responsibility in NHS England for delivery of most Five Year Forward View programmes: STPs, accountable care systems, new care models and most of the clinical improvement programmes.

The central question for all STPs needs to be “how do I optimise for my population?”, Mr Swindells said.

Speaking on Wednesday, Swindells said STPs had been created to break down the current model of health and care that was built around “a set of incentives to do the wrong thing”. The best STPs were “cutting through the crap” to deliver for their populations, he said.

“This is a system change, a channel shift.” 

However, this change would probably need to occur without the support of legislative change in the short term, he said. Mr Swindells said law change was unlikely, echoing similar comments from health secretary Jeremy Hunt at NHS Confederation conference earlier this month.

Mr Swindells said while the NHS compared exceptionally well to its international peers some “difficult conversations” were needed around delivery of care.

Some parts of the NHS which were still working the way they had 20 years ago, he said, citing the example of a GP practice that saw all of its patients face-to-face, while another used video for 20 per cent of consultations.

Many people were being treated in the wrong setting, whether at their GP or in hospital, while there remained unmet demands, he said. 

Delivering significant changes, replacing “lousy” ways of working with new models of care, was particularly important right now as NHS needed to showed government it was worthy of investment, Mr Swindells said.

“We need to prove we are an investable proposition, that if you put money in you get money back.”