The opportunities and risks of STPs

 Mike Adams 9 Nov 2017 West Midlands

In trying to meet as many health care and nursing leaders in the West Midlands as possible since my appointment in the summer, I’ve been keen to find out what impact the six Sustainability and Transformation Partnerships in the region are having.

STPs are big players. They are the partnerships responsible for reforming health and social care services in the area they serve by 2021 to meet future demand on the system, promote more effective integration and improve health and health outcomes, but, frankly, without anywhere near the growth in funding that most observers, including the RCN, believe is needed to truly realise this ambition.


What is immediately clear to me is that the commissioning authorities and providers that make up each STP have an unenviable job on their hands. At a time of unprecedented demand on health and social care, it’s not as if they can magically suspend the operating, staffing and financial pressures in the here and now to embed their master plan.

Unfortunately, what’s a little more murky is how much of a reference point the respective STP visions are for changes locally in how health care is organised and delivered; changes that are on our radar at the RCN because of the implications for nursing and our members; changes that we might endeavour to influence or resist. 

Changes such as the thinning out of school nursing and health visiting services due to Government cuts in public health funding. Does it matter if this has hasn’t been specified in the STP plan? It probably does matter, not least in the interests of clarity and transparency, but regardless, we support members through the potential fall-out from organisational and service changes every day.

Local Workforce Action Board

That doesn’t mean there aren’t advantages to being further upstream as the STP workforce plans are refined and implemented. Every STP has established or is establishing a Local Workforce Action Board and these will be the forums in which we and our fellow trade unions will scrutinise future workforce plans for their potential impact, good or bad, on nursing and patient care. Indeed, we’ll be exploring all possible options for engaging with STP programmes of work.

One of the meetings I had recently was with Andy Williams, Accountable Officer for NHS Sandwell and West Birmingham Clinical Commissioning Group and Chair of the Black Country STP, who said a two per cent rise in demand on health services in the Black Country is expected in the near future - an increase that will inevitably leave a big hole in funding based on current spending levels.

It was a worrying message to hear, but I was nonetheless encouraged by Andy’s appreciation that the current workforce is the key to the health care economy’s success and how important it is to value those employees.

In the Black County, the NHS employs around one in eight of the area’s working population, so it was heartening to hear that the STP leadership is committed to pursuing excellence in employment within the NHS locally to not only help staff feel valued and happy but also realise the resulting benefits of reduced sickness rates and increased productivity levels. 

In the current financial climate, any such efficiency gains will be crucial.

Mike Adams

RCN England Director

Page last updated - 05/09/2018