Half of STPs at an advanced stage, but rankings are ‘mixed blessing’

The 44 sustainability and transformation partnership (STP) footprints in England have been rated and ranked by overall performance for the first time since being set up in 2015, with over half in an advanced stage.

Each area was judged on a number of performance areas, including emergency departments, patient safety and prevention. Within these areas there were other more specific subcategories, such as A&E waiting times, number of 62-day waits and the emergency bed days rate that NHS England auditors used to get a picture of the performance of each STP area.

Almost half (45%) of the trusts were rated as “advanced”, and five trusts were given the top ranking of “outstanding”: Dorset; DDT, Hambleton, Richmondshire and Whitby; Frimley Health; Milton Keynes, Bedfordshire and Luton; and South Yorkshire and Bassetlaw.

Nineteen of the 44 footprints were described as “making progress” in the rankings. However, five – Bristol, North Somerset, South Gloucestershire; Humber, Coast and Vale; Northamptonshire; Staffordshire; and Sussex and East Surrey – were described as “needs most improvement”.

Amber Davenport, head of policy at NHS Providers, said the ratings presented a “useful picture” of where partnerships were progressing well, those that are yet at an early stage and those that may need more support.

“Local areas have identified that the transformation outlined in their STPs can only be achieved through capital investment,” she stated. “We are pleased that the £325m announced in the March Budget has now been earmarked for selected STPs, but we have consistently highlighted that a more substantial injection of capital funding is required this year. STPs cannot be expected to deliver plans which require capital without appropriate financial support.  

“Given trusts are already held to account for their contribution to the wider system through the NHS Improvement’s Single Oversight Framework, it is important that the national bodies remain consistent and that these new ratings do not result in different signals being sent to trusts and other STP partners about priorities to focus on.”

Decision to rate individual STPs a ‘mixed blessing’

And Niall Dickson, chief executive of the NHS Confederation, argued: “STPs will be critical in changing the way care is delivered all over England. We congratulate those rated outstanding today and note more than half are described as at an advanced stage.”

But Dickson added that it was a “mixed blessing” to rate STPs individually.

“There will be good reasons why some areas are progressing more slowly and it’s vital we give them the support they need, rather than point the finger,” he explained. “While there is a case for setting a baseline to measure future progress, we are concerned that the measures at this point must be relatively crude.

“It may make sense to incentivise those who are most advanced, and set a baseline for future progress but it would be a mistake to stigmatise partnerships that are at an early stage in their development. 

“Now is the time to encourage and nurture partnership working and support those who are seeking to foster collaboration at a local level – without it, services will continue to struggle to meet growing demand and patients will suffer. It is in everyone’s interest that every STP succeeds."

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