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.
So far, only one devolution agreement has been signed across Yorkshire and the Humber region. Devolution for the Sheffield Region was officially signed in October 2015 and covers the city of Sheffield, Rotherham and Doncaster. There are four other devolution proposals which involve the authorities in West, North and East Yorkshire in various combinations.
In total five devolution deals have been agreed across the 'Northern Powerhouse' – in Sheffield, Greater Manchester, North-East, Tees Valley and Liverpool.
Sustainability and Transformation Plans
STPs set out how each area is intending to reform health and social care services to meet future demands and financial pressures. In effect, STPs are local responses to the NHS £30bn funding gap. This is the difference between funds needed to maintain current NHS services, and what the Government is proposing to spend by 2020/21.
STPs outline how local savings will be achieved. On average, each STP area must make provision for saving around £450m by 2020/21.
There are three STPs across the Yorkshire and the Humber region and they need to make savings of some £2bn.
In order to make these savings, STPs aim to change the way care is delivered across the country.
Common themes in the plans:
- move care to local communities and social care
- more integration of health and social care
- review specialised services
- prevention, proactive care and personal responsibility
Read the three Yorkshire and the Humber plans:-
View a list of all STPs on the NHS England website.
STPs and the RCN
We're 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.
The implementation timescale for STPs, which will see plans agreed and up and running by April 2017, have meant that plans have been developed in isolation and secrecy. The RCN believes that there must be meaningful engagement and proper consultation with staff, patients and the local communities that use services. Read more.
- We will not support anything that compromises patient care
- Nurses and workforce are crucial to safe staffing
- Money savings must not be the main driver
- Essential community services and social care must be properly funded
- Nursing staff must be consulted
Help shape and influence your local STP or raise issues of concern:-
- Attend or contribute to a local STP consultation meeting
- Contribute to online staff or public 'conversations'
- Attend your local Council meeting
- Attend your local Healthwatch or Health Overview and Scrutiny Committee meeting
- Contact your local MP
- Speak to your local Councillor or Council
The Yorkshire and the Humber has seven vanguard sites piloting new models of care in different areas and health care settings. Click on the links for more information about each one.
Integrated primary and acute care systems – joining up GP, hospital, community and mental health services
Multispecialty community providers - moving specialist care out of hospitals into the community
Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services
Urgent and emergency care - new approaches to improve the coordination of services and reduce pressure on A&E departments
Acute care collaboration