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STPs offer ‘a new vision’ of integrated care, say Dorrell

Sustainability and transformation plans (STPs) should be used to deliver “a new vision” of integrated public services, with full local authority involvement, the chair of the NHS Confederation has said.

Stephen Dorrell is the independent chair of the Birmingham and Solihull STP board, which is one of just three in the country to have a leader from local government instead of the NHS (Mark Rogers, the chief executive of Birmingham City Council.)

Speaking at the Health+Care Conference, he said that having a local authority lead in an STP “reduces the risk of the STP simply talking to itself”.

“If the programme is to work, it seems to me it’s essential – it’s not an add on, it’s something which needs to be top and centre – that the STP process is about embedding the national health service in a broader range of public services,” he added.

Dorrell said Birmingham and Solihull’s work showed that STPs are “an extraordinary opportunity to create a new civic agenda” and cited Sir Howard Bernstein’s leadership of Greater Manchester Combined Authority, which recently became the first in the country to gain control of health services, as a model.

“If Howard was here,” Dorrell said, “he would say, as he always does, this is not about changing public services, this is about creating a sustainable community and engaging all of public services around the subject of a population and a place.”

He said that this should cover areas including employment, education and housing as well as health and care and that existing silos should be encouraged to work together.

“This is about starting in a completely different place and seeking to create a new vision of what supported public services ought to look like,” he said. “That seems to me to be the opportunity created by STPs. It’s clearer in those STPs that are led by local authority system leads.”

A recent investigation by NHE’s sister title Public Sector Executive revealed that Greater Manchester Combined Authority has had greater involvement in healthcare planning than other local authorities, suggesting that devolution is better than STPs at delivering integrated care.

Dorrell also said that the regulation system needed to change to accommodate changes in care.

“It’s important in the context of this changing sector that the regulatory structure changes to reflect changing services,” he said. “We talked about joining-up integrated services. What that will mean of course is different skill mixes, different professional services, a different pattern of service and it’s very important that the regulatory process doesn’t stand in the way of those changes, but actually they deliver effective monitoring of the standards being delivered.”

In another debate at Health+Care, Tom Jackson, chief finance officer and deputy chief officer at NHS Liverpool CCG, said that “not a lot of STPs”, which were due to be completed by all trusts today, are not ready to deliver the changes needed at this stage.

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