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10.05.17

STPs a ‘workaround’ for organisational flaws in health and social care

STPs represent a ‘workaround’ to serious deficiencies in the organisation of the health and social care system, a trustee from the King’s Fund has stated.

Speaking at the think-tank’s leadership and management summit yesterday, Dame Ruth Carnall, who has over 30 years of experience in healthcare including 20 years as a CEO, made the claim that though STPs were currently the NHS’s only option in terms of collaboration, they were also described as a way of covering up other parts of the NHS’s structure which were failing.

“At the moment, STPs are the only show in town in terms of organisational collaboration,” Dame Ruth stated. “They are a genuine attempt to facilitate system leadership across the board.

“But in reality, they reflect a workaround to some wholly flawed and fragmented organisational designs that we have now within health and social care that eventually we are going to have to face up to and tackle.”

She argued that the current system created stress for staff – as the relentless downward pressure of delivery, was coupled with a set of organisational frameworks that people find “almost impossible to grind their way through at an organisational level and at a patient level”.

Dame Ruth made the statement responding to an address from Professor Michael West, head of thought leadership at the King’s Fund, who argued that compassionate leadership at a staff and patient level was key to creating a sustainable health system.

He said: “The success of these collaborative STPs will depend on collaborative system leadership across organisations, having a compelling shared vision to transform the health and wellbeing of communities and a shared commitment to work together not just in the short term but for long-term continuity.”

Though Dame Ruth agreed with the need for compassionate leadership, she also said that “tough choices” were going to have to be made about STPs which would inevitably lead to some being disadvantaged.

“We have limited resources and choices are going to have to be made,” she said. “To make those choices we are going to have to have authority and in the end some authority is needed.”

“I don’t believe it overrides compassionate leadership – but people do need some certainty and clarity about what is going to happen. People need a framework within which they can work and they can innovate.”

Professor West and Dame Ruth were also joined in the discussion by Professor Julienne Meyer, a specialist in nursing for older people, as well as CEO of Bristol NHS FT, Robert Wooley, CEO of Phillips Neil Mesher and an expert by experience Nicci Gerrard.

The call follows other recent criticism of the STP programme, including the Royal College of Medicine’s chair, Dr Michael Dixon OBE, describing them as “totally aspirational” last week.

And before that, MPs in the Public Accounts Committee warned that STPs were unlikely to be more successful than the Better Care Fund in integrating health and social care more smoothly.

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Comments

Patrick Oades   10/05/2017 at 12:11

“At the moment, STPs are the only show in town in terms of organisational collaboration,” Dame Ruth stated. This is incorrect. There are many examples of clinical networks that cross both secondary and primary care boundaries. Oncology, cystic fibrosis, neonatology and vascular surgery to name a few. Sub-specialty training and education also crosses boundaries. Unlike the STP's many of these initiatives are established on good will and in the absence of specific funding. Dr Patrick J Oades MB BCh MA MRCP FRCPCH

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