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Warning STPs must engage with councillors to create credible plans

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Leaders of sustainability and transformation plans must prioritise “meaningful engagement” with local authorities and the public in order to develop credible plans for health and social care integration, according to the King’s Fund.

A report published today into progress across the country’s 44 STP ‘footprints’ also says additional funding would be needed to deliver the plans, with cuts to social care and public health budgets creating significant barriers to strengthening community services and relieving pressure on hospitals.

The report, based on analysis of draft proposals published in October, said the involvement of councils to date in the development of STPs had “varied widely” across the country.

It added that extending involvement in the development and implementation of STPs beyond a small number of NHS leaders was an “urgent priority”. There are currently four local government leaders of STPs, although the future of Birmingham and Solihull’s is in doubt following the announcement that Mark Rogers is to leave his role as Birmingham City Council’s chief executive.

The report also said gaining the support of the public and politicans would be essential if some of the more “radical” proposals for the reconfiguration of hospital services were to be implemented.

At a briefing last week ahead of the report’s publication, King’s Fund chief executive Chris Ham said: “Local politicians who do not support changes when they are backed by clear evidence would be colluding to prevent improvements in the quality of people’s care – they must step up to the plate.”

The report found that detail and evidence was often missing from STP plans on specific programmes for prevention - a key requirement of the NHS Five Year Forward View - while cuts to public health budgets would “make it difficult to sustain existing preventative services, let alone expand them”.

The report said NHS staff and leaders were currently preoccupied with tackling financial and service pressures, with a risk this could “crowd out capacity and capability” to transform care.

It said there needs to be more “explicit recognition” of the role of new care models in enabling social care and the NHS to deal with “operational challenges”.

The report added: “If this does not happen, the urgent will drive out the important and STPs will not receive the attention they need if they are to provide the sustainable solutions to the pressures facing the NHS and social care.”

Mr Ham said some NHS trusts facing financial pressures were investing in social care services in an attempt to address demand on hospitals.

“There is an increasing amount of trusts saying, ‘This is a sign of how difficult things are’ and this will become more common in the future,” he said.

The report also called for STPs’ governance and decision-making processes to be strengthened and formalised to align planned collaboration with the “sovereignty, accountability and legal duties of the boards of NHS organisations and local authorities”.

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