STPs in the North West

 Estephanie Dunn 10 Oct 2017 North West

The aim of the STP programme is to ‘bring local health and care leaders, organisations and communities together to develop and implement plans for their localities to with the aspiration to improve population health and organise care delivery in a way that avoids gaps and overlaps in provision. 

By shifting the focus from individual organisations’ and focusing on health gain for more people, reducing the number of deaths from cancer, improving life chanced for children and young people through engaging them to manage their own health more effectively. Despite these laudable ambitions, they continue to pose more questions than offering answers or solutions at the moment. 

Much of this relates to the how, how can these plans be afforded in a system that is increasingly financially challenged? How can we find staff with the knowledge, skills and experience to deliver services in new and innovative ways? and how can we maintain the ‘here and now’ whilst transitioning to new ways of delivering services within a fixed and overburdened budget?                           

What does the acronym STP stand for? Originally STPs were sustainability and transformation plans. Now it seems that they are sustainability and transformation partnerships. So when did vague plans become a partnership? What are the partnerships trying to achieve? Who knows about them? How can we get involved as professionals and as citizens? 

There are 44 STP footprint areas across England, each claiming to be transparent. Many of our members are unaware of the tectonic shift and changes in motion to the health and social-care landscape. No one can argue against the fact that our health and social care sector is in crisis, both financially and in terms of capacity. However, the STPs do not go into detail about how they will overhaul the system to prevent ill health, join up services, and deliver care in more appropriate settings.

Information about the three STP’s that are in the North West region, has been published and although RCN staff, reps and members have been analysing these complex and lengthy documents and despite their noble intentions. Devolution plans have greater detail in them whilst the remainder are frustratingly lacking in detail. 

The plans contain little or no information about the implications for nurses and healthcare practitioners. Nursing staff are ideally placed to know what works best for the people they care for. The RCN is calling for nurses be involved in plans as they develop, not as an afterthought. It is unacceptable that nurses are having to second guess what will happen to their profession and at a time that is already on its knees, with a cap on pay, axing of the student bursary and an uncertain future for EU members, all of which contribute to the recruitment and retention crisis.

This is why the RCN continues to work hard so that the voice of nurses is heard. We are requesting a presence on planning committees and we are asking for discussions with the people behind the plans. However, this is proving to be a challenge in some areas as various committees are being held behind closed doors, meetings are being cancelled, and we remain in the dark. 

Only a third of STPs are set to receive additional funding to improve aspects of care within their footprints. Where does this leave the others? Reports in the HSJ highlights a withholding primary care development funding to two area in the north-west in order to save money in the longer term. To achieve the step change in health and well-being for our communities, investment is needed to ensure the infrastructure is established before big changes are made. Staff and people who use services must be reassured by the government that STPs aren’t simply a cost cutting exercise to balance the books without considering the effect on the service users, communities and the nursing workforce.

There is no doubt that if successful, STPs could help improve the health of the nation and in theory, the RCN supports their aims, but only if the reality matches their ambitions.
Estephanie Dunn

Estephanie Dunn

Regional Director, RCN North West

Estephanie Dunn has a lifelong background in nursing, spanning the independent sector and NHS. Prior to becoming Regional Director for the RCN North West Region in August 2014, Estephanie worked as the Operational Manager for the RCN’s Northern Region.


Page last updated - 05/09/2018