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20.06.17

STPs need necessary legislative power and support to be implemented, experts warn

Experts have warned that none of the 44 STP areas are ready for implementation due to a number of factors including funding difficulties, poor planning and a lack of clarity regarding STP leadership.

In a report, called: ‘Sustainability and Transformation Plans: How serious are the proposals? A Critical Review’ researchers from London South Bank University (LSBU) found major issues with STPs that may prevent them from being fully implemented on time.

Some of these challenges were also found to be difficulty collaborating across multiple organisations in financial challenge, the speed of planning that is now required, as well as a lack of focus on reducing demand before switching resources away from the acute sector.

The report also argues that the STPs need to be given legislative powers and support to achieve effective collaboration, as well as much needed clarification on their role. The news comes after Jeremy Hunt announced last week that STP legislation would now be pushed back to after Brexit due to the UK’s unexpected election result.

The findings also recommend that STP leaders needed to plan ahead based on the reality of their current situation and identify changes that were evidence-based, whilst also ensuring that workforce plans were suitable for their ambitions.

Overall, the authors of the report point to: “a distinct lack of comprehensive planning and evidence-based policy making, in all 44 STPs”, that may lower the likelihood for STPs to deliver the scale of change required for the future of the NHS.

LSBU researchers also proposed that a viable business case must first be established to take full account of the proposed changes to the health and care system and to ensure that sufficient staffing and adequate capital were made available to establish new services and prove their effectiveness, before existing services are reduced. 

“The health and care system needs time to develop partnerships, and a legislative and accountability framework that fosters collaboration,” said co-author of the report, health economist Seán Boyle.

“That is why this report recommends a constructive overhaul of each of the 44 STPs, looking at the appropriate framework for that work in terms of geographic area and what parts of the health and care system should be involved including the stakeholders for that area of work, the partnership agreements required and the accountability to the population of the proposed changes.”

Professor Rebecca Malby at LSBU’s School of Health and Social Care, who commissioned the report, said: “There is an acute need for the evidence base supporting the case for change in each of the 44 STPs within the NHS to be substantiated further before the service commits to launching plans for widespread ‘transformation’.  

STPs also need time to clarify and develop their leadership function – moving from a top down command and control approach to a planning and enabling approach.”

Professor Warren Turner, Dean of LSBU’s School of Health and Social Care, stated that with tightening financial pressures on the NHS and social care the weakness or absence of serious workforce plans means “there is little reason to believe that these ambitious reductions in demand and pressure on acute services will be achieved in the timescale proposed”.

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