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RCN Eastern Region

Integrated care in England: Eastern region

Sustainability and transformation plans (STPs)

There are six STPs in the RCN Eastern region area. The plans cover the period 2016 to 2021 and set out how each area is intending to reform health and social care services to meet future demands and overcome a funding shortfall of £22bn across the NHS in England over this period. The RCN is concerned that without extra funding to ensure there is sufficient provision to realise 'the right care in the right place at the right time' aspiration of the plans, there is a risk they will not deliver their intended outcomes for patients and service users. 
RCN Eastern staff are actively involved in monitoring the region’s STPs, meeting with key players and seeking to make sure that the voice of nursing is heard in their development and implementation. Here is a summary of the most recent updates from the STPs:

  • Cambridgeshire and Peterborough  Regional Director Teresa Budrey has met with Matthew Winn, chief executive at Cambridgeshire Community Services and also STP lead for this STP. He spoke with Teresa about how unions could have a seat on Local Workforce Boards (LWABs). 
  • Norfolk and Waveney   Former Health Secretary Patricia Hewitt has been appointed as the Independent Chair for the Norfolk and Waveney STP, taking over from STP interim Chair John Fry, also the Chairman of Norfolk and Norwich University Hospitals. South Norfolk Clinical Commissioning Group has also published a document setting out Norfolk and Suffolk Foundation Trust’s plans to progress mental health aspects as part of the Norfolk and Waveney STP.
  • Suffolk and North East Essex   Ipswich and Colchester hospitals have started a formal consultation around their future working relationship with a strong recommendation for a full merger of the two trusts. The RCN’s Essex team is monitoring these developments.
  • Milton Keynes, Bedfordshire and Luton  The STP has become an Accountable Care System which is the enabling status for a faster track implementation process. The 16 NHS providers and local social care providers are developing an alliance infrastructure of collaboration for governance and financial management and it seems mergers of the statutory bodies are likely. A Collaborative Investment and Savings Programme (CISP) is being formulated which will project manage changes to secondary care and the necessary changed provision to primary care. The STP has facilitated staff, patient and public engagement, although it has been accepted this has been NHS secondary care oriented to date. This is now being remedied with greater emphasis on social and primary care input. Following enhanced consultation it is anticipated specific change proposals will be the subject of formal consultation in the latter part of 2017 with implementation in early 2018. In addition, Bedfordshire on Sunday has reported that Bedford's Mayor is calling for the healthcare review board to scrap its idea of downgrading local hospitals, after a report revealed public, patient and NHS staff opposition. The document published in March contained ideas including reducing A&E services in at least one of the three local hospitals and removing consultant-led maternity care in at least one hospital. The mayor was reacting to a report the STP published summarising the feedback it has received.
  • Hertfordshire and West Essex   Senior Officer John Wilkinson has met with Hertfordshire and West Essex STP lead and CEO of Herts Partnership NHS Foundation Trust and other trade union fulltime officials to receive an overview of STP activity and to agree the terms of reference for a workforce stream steering group. The emphasis upon service quality was stressed, although prominent attention was drawn to the need to remain inside a £90m deficit and to prevent a five-year projection on a £400m deficit if service redesign is not undertaken.
  • Mid and South Essex.   Three local staff sides have now agreed in principle terms of reference for the new joint senate. Senior Officer Tony Durcan met with joint executive members including Tom Abell, Director of Transformation, to discuss the new senior organisational proposals which in essence is moving most senior posts down from band 9 to 8Ds. This is affecting several RCN members. The system will be the blue print of the next stages of the new structures. 

View a list of all STPs on the NHS England website.

Read about the RCN's view on STPs.


An East Anglia devolution deal was published in March 2016. Since then two deals within the region have been proposed – Norfolk/Suffolk and Cambridgeshire/Peterborough.

The proposed Norfolk/Suffolk deal has been endorsed by all councils in Suffolk and some in Norfolk. Other Norfolk councils have decided not to press on with a combined authority at this stage. All the Cambridgeshire and Peterborough councils have agreed their proposed deal. Details are awaited on the extent to which devolution will cover health and social care.

Elsewhere in the Eastern region discussions continue about potential devolution proposals and what shape, if any, deals in Essex, Bedfordshire and Hertfordshire will take.

More information about devolution in East Anglia is available here:

Vanguard sites

The Eastern region has two vanguard sites piloting new models of care in different areas and health care settings.

Click on the links for information about each one.

Urgent and emergency care – new approaches to improve the coordination of services and reduce pressure on A&E departments.

Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services.

Integrated care in England

Find out more about the three ways integrated health and social care is set to be delivered in England and what it all means for you.