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Sustainability and transformation plans (STPs)

‘Sustainability and Transformation Plans’ (STPs) are one of the ways that health and social care integration is being developed across England. If you work as a member of nursing staff in England it’s highly likely that you will be affected by the proposals contained in your local STP.

What are sustainability and transformation plans (STPs)?

The aim of the STP programme is to bring local health and care leaders, organisations and communities together to develop plans for their localities (or ‘footprint’ areas) to develop a holistic approach to meeting the health and care needs of a whole population, rather than users of individual services or organisations.

A key element of each STP should be how it will enable the organisations working in the footprint areas to achieve the Five Year Forward View’s aims of improving population health and wellbeing, transforming the quality of care delivery and achieving sustainable finance. The plans will cover the period from October 2016 to March 2021.

The next steps for STPs were announced in the Next Steps pamphlet published by NHS England in March 2017, and include every STP turning into a ‘Sustainability and Transformation Partnership’ over the next few months.

Each Partnership will have an operating board to oversee its activities, drawn from its constituent organisations, and will appoint a leader, who will be need to be ratified by NHS England. Each STP will also be required to work more closely with the clinical commissioning groups (CCGs) and any commissioning support units (CSUs) in its area, to develop its programme management capacity.

In some areas, as yet to be announced, the STPS will also be responsible for developing integrated (or accountable) health systems.

One welcome commitment in Next Steps, is for leading STPs and ACSs to work with staff and trade unions to de-risk service changes, for example through supporting flexible working. This begins to address concerns that the RCN has consistently raised, both locally and nationally, about the impact of STP leaders’ decisions on members working arrangements.

How STPs will impact patients

The STPs must provide solutions to improve care across a range of areas, including:

  • improving quality in general practice
  • making sure access standards for A&E and ambulance waits are met
  • ensuring that people wait no more than 18 weeks from referral to treatment at hospital
  • meeting the 62 day cancer wait standard
  • implementing the two new mental health access standards for referral and treatment
  • transforming care for people with learning disabilities.

They must also have reduced health and wellbeing gaps within communities, and generally improve the quality of care delivered locally. They must also align with any vanguard or other new models of care sites in their area.

How STPs will impact nursing staff

STPs should be written in partnership with clinicians, including nursing staff. Nursing staff must be actively involved and engaged in these plans from conception to delivery, to ensure they make full use of nursing skills and knowledge.

Workforce productivity and standardisation of care across STPs will be a priority, as well as the roll out of digital healthcare and a focus on health promotion and disease prevention. This could lead to significant changes in how healthcare is delivered, especially with the current emphasis on financial savings and affordability.

Nursing is key to the delivery of these plans but STPs will only be sustainable if savings are delivered through a reduction in bureaucracy, whilst maintaining quality.

Where the STPs will be

There are 44 STPs across England and they differ in terms of size of area and population figures – you can view a full listing of all the STPs on the NHS England website. Regional information on STPs is available here:

Information on developments in other regions of England will be available here soon.

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.