Integrated care has become a key focus of reform in England as a response to a need to deliver further efficiency savings. Sustainability and transformation plans (STPs) and devolution are part of a number of wide range of new initiatives to develop and deliver integrated care. Read the RCN's policy briefing 'Integrated Health and Social Care in England: update', published in April 2015.
Sustainability and transformation plans (STPs)
Sustainability and transformation plans (STPs) were announced in the NHS England 2016/17 Planning Guidance, published in December 2015 as part of the Five Year Forward View. They aim to ‘bring local health and care leaders, organisations and communities together to develop local blueprints for improved health, care and finances over the next five years’. Across England there are 44 STPs, known as footprints. View a list of all STPs on the NHS England website.
Each STP has a named ‘leader’ who is responsible for ensuring the final plans are written in partnership with community input. These plans, rather than being based around institutions, are locality based, reflecting the needs of the community rather than what an institution wants to provide. The STPs are backed by £560 billion of NHS funding, with the first wave of funding being awarded to the most credible and compelling plans.
There are seven STPs in the South East region. You can read the plans by following the links below:
- Bedfordshire, Luton and Milton Keynes
- Buckinghamshire, Oxfordshire and Berkshire West
- Hampshire and the Isle of Wight
- Frimley Health
- Surrey Heartlands
- Sussex and East Surrey
- Kent and Medway
The STPs must provide details about:
How health is going to be radically improved to address the health and wellbeing gap; this will include for example how to prevent the causes of ill health such as diabetes and obesity, how to engage with the population to encourage them to take care of their own health.
How the new models of care will improve quality, what new models are to be rolled out across the locality, how digital health care will be rolled out? By changing the way that care is delivered how the quality of all services will be improved
How the finance and efficiency gap will be closed. How workforce productivity will be increased through initiatives such as e-rostering and what will be done to improve the use of the NHS estate.
The pace of change is fast and the intention is that it will increase. STPs all have three work streams established to address the three gaps from the Five Year Forward View: care models, finance and workforce. Changes to care models will impact on workforce in terms of the numbers of staff and the skills needed. We need to ensure that employers involve their staff sides in the development of the local operational plans. RCN senior officers will be in regular contact with the lead for each STP in their patch. Now each NHS organisation is working to develop an operational plan for 2016/2017 to demonstrate how it will deliver what the STP has set out. These will be submitted to NHS England.
The nine ‘must dos’ for 2016/2017 within the operational plans:
- Develop a high quality and agreed STP.
- Aggregate financial balance.
- Address and sustain quality in general practice.
- Ensure access standards for A&E and ambulance waits are met.
- Ensure no more than an 18-week wait from referral to treatment at hospital.
- Deliver the 62-day cancer wait standard.
- Achieve the two mental health access standards.
- Transform care for learning disabilities.
- Make improvements in quality while maintaining affordability.
The 3SC (East and West Sussex and Surrey) are not involving health/social care at this stage but taking advantage of the Government's commitment to devolving powers and resources to a local level, allowing authorities to make collective decisions about key services affecting the whole area. Further plans for the region are still at discussion stage with the local authorities at present.
The South East has five vanguard sites piloting new models of care in different areas and health care settings. Click on the links for information about each one.
1. Integrated primary and acute care systems - joining up GP, hospital, community and mental health services.
2. Multispecialty community providers – moving specialist care out of hospitals into the community
3. Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services
- None in the South East
4. Urgent and emergency care – new approaches to improve the coordination of services and reduce pressure on A&E departments
- None in the South East
5. Acute care collaboration vanguard sites