Betts: STPs will only work if all players are involved

Sustainability and transformation plans (STPs) are only going to work if all players, including local government and the voluntary sector, are involved, the chair of the Communities and Local Government (CLG) Committee has told NHE.

Speaking to us shortly after the chancellor’s Spring Budget, where he unveiled an extra £2bn for social care funding, Clive Betts MP said that the STP model can’t be purely health-driven.

“The problem is that the health service has got most of the money, and it is so short of money that it doesn’t have the flexibilities it might need to implement the STPs,” he argued.

During last week’s Budget, Philip Hammond revealed an extra £325m to support “a small number of the strongest STPs” that are already in a position to implement their plans.

Responding to this news, Betts said: “It [the funding] might be interesting in kicking some of them off, but nobody I speak to thinks the level of efficiency savings can be delivered at the same time as transforming a service.”

Discussing council involvement in STPs, which he described as patchy, the CLG Committee chair argued that “in some areas local government has been pushed aside and ignored”.

“In others, like Sheffield, which I represent, the STP has involved the council and voluntary sector. An effort has been made there and it was apparent,” he added.

Prior to the chancellor’s STP funding allocation, BMA analysis suggested that an estimated £10bn will be needed to get STPs off the ground, and Betts said he was not surprised at those figures.

“The simple reason is that, if you are going to do major transformations to service delivery, you can’t stop what you are doing and deliver something new,” he said.

“There is almost always a period of dual running and reorganisation while you change things. If you are going to reduce the amount of provision in acute hospitals, and get more in the community for prevention, you need a period of transition. Prevention is great, but it takes time to have an impact.”

Reflecting on the extra funding for social care, Betts, whose committee is conducting an inquiry into this area, said: “Obviously, we are pleased that the chancellor has recognised that the problems of social care need more money, but are disappointed that he hadn’t gone as far as the committee asked.”

His committee had also requested a National Audit Office review to establish a figure that everyone could agree on with regards to the social care funding gap, but “the government didn’t even mention that”.

“To pluck another £1bn over two years and say that is enough misses the point,” said Betts. “The chancellor can’t be certain it is enough; he has no credible evidence to back it. And we could be back here in a year’s time having the same argument.”

While admitting that health and social care integration can go some way to reducing the stress on both systems, the committee chair noted that as NHS England’s chief executive, Simon Stevens, told them, “integrating health and social care will bring benefits, but it won’t solve the problem of social care funding in the long term”.

The Sheffield South East MP added: “If anyone thinks all we have to do is get social care and health to integrate and then everything will be fine, then they are missing the point. We are still going to have a continuing need for extra funding for social care, simply because of demographics.”

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John King   13/03/2017 at 12:49

Good article. We are using simulation based approaches to 1) engage health and care communities to engage initially, 2) support them through the STP planning and transformation process and 3) in the longer term facilitating continuous system development. Be interesting to compare note as to extending developments to Social Care.

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