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Sustainability and Transformation Partnerships (STPs) 

Sustainability and transformation partnerships (STPs) build on collaborative work that began under the NHS Shared Planning Guidance for 2016/17 – 2020/21, to support implementation of the Five Year Forward View.

STPs are supported by six national health and care bodies: NHS England; NHS Improvement; the Care Quality Commission (CQC); Health Education England (HEE); Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE).

There are currently 44 STP footprint areas over England. They are made up of the following:

Health sector organisations
Local authorities
Third sector organisations
Community partners

The STPs' first task was to develop STP plans for the next five years; up to year 2020 / 2021.

You can find out more information and watch a short film about STPs on the NHS England website.

The role of STPs 

Each STP comprises commissioning and provider NHS organisations and local councils who with the partnerships in local STPs provide a way to use existing services more effectively, ease demand on hospital care and to improve the quality and safety of care across the system. The outcomes should be healthier people with more control over their own health, more joined-up, effective services and a health system that is sustainable for future generations.

The STPs require what is termed a ‘place-based’ approach to care and demonstrate how their service will meet the evolving needs of their patients over the coming five years. 

STPs need to demonstrate how services will be funded considering the expected increase in demand alongside the anticipated decrease in funding. The plans need to identify more efficient ways of working between and within the services. The partnerships between organisations need to ensure that commissioners and providers work together more effectively to best meet the needs of patients and avoid duplication of work. 

The proposals have had to consider the implications of carrying on providing care in their current form i.e. ‘do nothing’. Many organisations are already in deficit (i.e. are in debt), population size and the demands on health care are increasing and as such ‘doing nothing’ is not a viable option. The challenge is therefore to achieve quality integrated care within an affordable sustainable budget.

The RCN's position on STPs

The RCN has advocated that STPs should be developed in partnership with local clinicians, and nursing is key to their successful delivery. The proposals will only be sustainable if savings are delivered through a reduction in bureaucracy, whilst maintaining quality. The need to work across the system will mean working differently with significant changes in how healthcare is delivered, especially with the current emphasis on financial savings and affordability. Lack of staff engagement is a potential barrier to the effective implementation of change. Staff input and insight about the challenges facing the local health and care systems where they work is essential. 

The future of STPs

Plans for all 44 STP areas are available here. The proposals are from October 2016 through to March 2021 and are built around the needs of local populations.  Their aims are to make improvements and efficiencies to health services with a focus on prevention and early intervention and the delivery of holistic services. The NHS England pages on STPs also include blogs and articles and FAQs.

The intention over the next few years is that the STPs will develop and the partnerships which have evolved will become forums for shared decision making, supplementing the role of individual boards and organisations within the STP footprint areas. The immediate aim will be to refine and implementing the local plans so that patients can see practical benefits in their local health system. Some of the STPs are likely to become ‘accountable care systems’, in which those who provide services and those who pay for them come together with a combined budget and fully shared resources to serve a defined population. For further information go to our Place based care and devolution page. 

In July 2017 a Sustainability and transformation partnerships progress dashboard was published. NHS England intention is to update the dashboard on an annual basis in order to track progress. Its methodology may also develop at the process evolves.

Useful resources

Kings Fund (2015): ‘Place-based systems of care’
NHS (2014): ‘Five Year forward View’ 
Next steps on the NHS forward view ( 2017)  
Where to look’ packs for STP footprint areas 

Place based care

Care closer to home

Devolving power and responsibility about health and social care to local areas.
New models of care

New models of care

New ways of delivering health and social care at a local level.