Stevens: 44 transformation patches will cover England

The NHS England chief executive also defended the STP exercise, saying that national teams had not imposed the patches and he was aware of the difficulty and ambiguity in the strategic planning process.

The size of the population covered by the STPs varies from 300,000 to 3 million.

In the North of England and London the average population covered was 1.8m-1.9m, which suggests six or seven CCGs and seven or eight trusts. In the South and the Midlands and East, the average population was 1m-1.1m, covering three or four CCGs and a similar number of providers.

“We’ve actually not been prescriptive, at least not nationally, about the footprints,” Mr Stevens said at an event at the King’s Fund.

They were “umbrella plans that are the basis for bringing a manageable number of people together to have the difficult conversations”, he said.

Mr Stevens said most STPs had identified their “single leader” for the programme. However, there were a small number where no chief executive was “available or suitable”, and where NHS England was working to appoint someone “independent” to the role. In some of these areas it was because leaders were too busy with other tasks, but in others it was because relationships were too poor or there were no leaders of sufficient “calibre”.

He did not identify these areas and NHS England does not expect to reveal the 44 STP areas this week.

Of the leaders who have been appointed, Mr Stevens said, “about half at the moment” were CCG chief officers or chairs. The rest are NHS provider and local authority chief executives, he said.

Some NHS leaders and commentators have highlighted confusion about elements of the STP process, and there has been substantial local debate about the difficulty of deciding a fixed patch for planning. An HSJ editorial on Monday raised concern about confusion surrounding it.

Apparently referring to concerns about the process, Mr Stevens said NHS England was aware there was no “black and white answer to this”. It realises there are “shades of grey” in planning and joint working, he said. “We’ve all got to live with ambiguity.”

In relation to concerns about the requirement to produce an STP by the end of June, he said: “There’s a trade-off between the depth of the process and the speed of the process… The reality is that of course this will not mark the end of the line for the change process, but on the other hand what we can’t do is kick this can down the road to autumn or next winter.”