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04.05.17

CIPFA calls for ‘reality check’ on success of STPs

The potential success of England’s 44 STPs hinges on health leaders setting realistic targets for what savings can be achieved within set timeframes, a report has found.

In a report released by the Chartered Institute of Public Finance and Accountancy (CIPFA), called ‘Reality Check: next steps in developing sustainability and transformation plans’, financial experts argued that though STPs represent a good step forward in driving integrated place-based care, the need to deliver savings quickly was leading to proposals not being as effective as they could be.

CIPFA said that the timescales the NHS had set to implement STPs had led to a ‘business as usual’ attitude towards forming plans, which was damaging the potential for savings to be delivered.

It also called for the development of concrete, transformational changes to properly achieve the ambitions set out for STPs when they formed.

“The most obvious requirements for success are realistic plans which propose appropriate actions and a culture of genuinely sharing and working together,” the report read.

On top of that, CIPFA called for greater upfront capital investment to ensure that systems and infrastructure are in place for success, as well as revenue – which will stabilise budgets in the longer term and ensure there is sufficient change management capacity for success.

Finally, the organisation recommended that STP leaders put in place better contingency measures to manage the risk of STPs.

“The right planning system is a necessary part of identifying the key issues and assessing how to tackle them,” the report continued. “It will not, though, make it easy to sort inherently difficult conflicts.

“There remains the very real tension between short-term actions to balance the books and satisfy NHS regulators now and a longer-term set of strategies to create sustainable and transformed economies.”

Chief executive of CIPFA Rob Whiteman added: “Service integration is a no-brainer for patients, families and stretched NHS teams and as a means of addressing the need for financial stability in the health sector, STPs offer a promising start towards taking forward the changes needed in the health and social care system.”

But he also argued that after reviewing the 44 plans, it was clear that a lot needed to be done in developing full-scenario planning and understanding risk.

“Transparency and realism is crucial, even if it does expose the difficulties involved in achieving the plans,” he explained. “Otherwise there is a danger that the desire to present a positive position will lead to unrealistic judgements being made.

“To this end, CIPFA is keen to support finance leaders, from both the NHS and local government, involved the preparation of STPs so that they feel able to represent a realistic assessment of the financial position.”

CIPFA’s findings closely follow MPs on the Public Accounts Committee stating that they did not believe that STPs could be successful where other integration initiatives like the Better Care Fund had failed. It also comes just a day after the Labour Party pledged to have a ‘moratorium’ on what it called the Tories’ “chaotic” STP programme.

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