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Stevens: councils should take on STP 'decision rights'

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NHS England chief executive Simon Stevens has said some councils should take on “decision rights” in the development of sustainability and transformation plans.

Giving evidence to the public accounts committee yesterday, Mr Stevens was questioned on governance arrangements for the process of integrating health and social care in 44 footprints across the country, following concerns that councils had been side-lined in some areas.

Mr Stevens said: “There are a number of parts of the country where we would be looking to local authority leadership to take on more of the decision rights…and drive the thing forward.”

NHS England earlier this month said the Five Year Forward View delivery plan, due in March, would “beef up the implementation capability which exists at STP level”.

Mr Stevens at the time said STP leaders would be given the right to “recommend” member trusts and commissioners reorganise, where the “veto power or inertia” of individual organisations is holding up change.

Department of Health permanent secretary Chris Wormald told the committee the focus would be on “moving things forward” while retaining the current “statutory position” of organisations involved in STPs.

Mr Stevens added that this was about “pushing as hard as possible” against the current legislative framework “without parliament having to legislate”.

He added that between six and 10 STPs were moving to “accountable care” structures that would “end the purchaser-provider split” in the NHS.

Sarah Pickup, deputy chief executive of the Local Government Association, told the committee that local authority involvement in the STP process had improved.

But she said complexities continued due to the fact that the STP footprints were not coterminous with local authority areas.

Ms Pickup said it was “critical” that councils and health & wellbeing boards were used to engage with communities and help provide the “building blocks” to bring STPs together.

She added: “If councils are properly engaged early about ‘the what’ and not ‘the how’ there is real potential.”

Jo Farrar, director general for local government and public service at the Department for Communities and Local Government, said integration of services had led to improvements in levels of emergency hospital admissions and delayed transfers of care in areas such as Northumbria, Bedford and Newcastle.

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