New HSJ channel showcases work of STP pioneers

STPs face many challenges but have the ability to improve healthcare while also enabling the NHS to live within its means.

Dr Amanda Doyle, STP lead for Lancashire and South Cumbria, spoke of the poor health outcomes some people in the area had – and the need to do the best with the resources available by delivering health services differently. She emphasised that the area’s finances were not sustainable and it could not continue to deliver services in the way it had done.

“We have put a lot of effort into getting our governance right,” she said. ‘It is important because some of the decisions that we are going to have to make will be difficult.’

The STP had ensured that local authorities, commissioners, providers and Healthwatch were all round the table – “sometimes it is like a cast of thousands”, she said. As the STP moved into a design phase and came up with concrete plans, there would be much more public involvement.

Financially, there was a challenge around getting themselves in a reasonable position this year and also in 2017-8.

Capacity issues

In Nottinghamshire, the STP is led by David Pearson, director of adult social care at Nottinghamshire County Council. Its aims include promoting independent and increasing healthy life expectancy for the population by three years during the life of the plan. Like many areas, it wants to reduce the use of acute hospitals when people can be looked after at home, and wants to explore the use of assistive technology and digital care.

Matthew Swindells said around 10 STP areas were nearly there, the majority were making progress but there was a “similar distribution” of STPs below this

But he described it as grappling with a tiger’ to get to the point where there was confidence that they could go out to the public. There were capacity issues and he urged other areas to be clear about what level of planning was needed to take the next steps and when a plan was ‘good enough’. 

Dr Doyle echoed this: “This isn’t my job but it is rapidly becoming what I spend most time on. This takes a huge amount of time and energy to deliver.”

Matthew Swindells, NHS England national director of operations and information, said STPs faced a challenge of reducing health inequalities, improving quality and doing all this within the financial envelope. He said around 10 STP areas were nearly there, the majority were making progress but there was a “similar distribution” of STPs below this.

There has been no NHS England stipulation that plans should not be published but he said NHSE would discourage publication of plans which were still being worked on.