With the major parties all committed to further increases in healthcare spending, much of the debate in this area in the run up to the General Election has been dominated by a single acronym: STPs – sustainability and transformation plans. The Conservative manifesto pledges the continued introduction of STPs as part of the party’s commitments to implementing the Five Year Forward View (FYFV), provided they are ‘clinically led and locally supported’. Meanwhile, Labour has pledged to ‘halt and review’ their introduction, stating that they are ‘looking at closing health services across England’. In this environment, it is worth exploring what exactly STPs are and how they will impact the health technology sector.
What are STPs?
NHS England states that STPs are ‘place-based’ plans responsible for improving health and care services in their local areas, and are ‘built around the needs of the local population’. STPs are partnerships between NHS England and local councils, and are also supported by NHS Improvement, the Care Quality Commission, Health Education England, Public Health England and NICE. There are 44 of them across England and they hold responsibility for the local implementation of the Five Year Forward View.
Why have they been set up?
As explained by NHS England, STPs have been set up to help meet the so-called ‘triple challenge’ identified in the Five Year Forward View: achieving better health, transformed quality of care delivery, and sustainable finances. Clearly, the key challenge set out in the FYFV was the £22bn financial gap that it identified would open up by 2020/21 and NHS England sees the establishment of STPs as a key step in driving efficiencies.
What impact will STPs have on the NHS and what does this mean for health tech?
Respected health think tank The King’s Fund describes STPs as marking ‘a decisive shift away from competition as a means of improving health services by requiring NHS organisations to collaborate with each other and with local partners’. Although there is no sign that STPs will replace CCGs, it is widely expected that they will increasingly be used to coordinate commissioning plans. This is intended to assist NHS England in finding efficiencies through commissioning at scale. It is clear that, if STPs continue to be introduced, companies in the health tech sector will need improve their understanding of the changing commissioning environment and the challenges and opportunities it brings.
Critics of STPs have claimed that their development has lacked involvement from patients, the general public and staff and that local authorities also have not been engaged with sufficiently. Furthermore, some STP proposals which would change the roles of hospitals and specialist services in their communities have attracted criticism.
What does the future hold?
After a series of delays, draft proposals for all 44 STPs have been published and are now being discussed by a range of stakeholders, including clinicians, local staff and communities, trade unions, the voluntary sector and others. With most polls still predicting a majority Conservative government, it is very likely that – despite their troubled beginning and likely future obstacles – the introduction of STPs will continue.