Sustainability and transformation plans

Abstract

The policy that will guide health services to 2021 was published in December: Delivering the Five Year Forward View NHS Planning Guidance 2016/17–2020/21 (NHS England, 2015). The document is authored by all the partner organisations that deliver and oversee NHS services: ■NHS England ■NHS Improvement (Monitor and the NHS Trust Development Authority) ■Health Education England (HEE) ■The National Institute for Health and Care Excellence (NICE) ■Public Health England (PHE) ■Care Quality Commission (CQC) The most salient point within this framework is the requirement for development and agreement of a sustainability and transformational plan (STP). The plan tasks organisations with determining their most locally critical milestones for accelerating progress in 2016/17 towards achieving the triple aim as set out in the Five Year Forward View, which covers population health, experience of care and best value for money (Figure 1). STPs are central to a new wave of change that will sweep away many of the changes that resulted from the coalition government’s 2012/13 NHS reforms, and the implementation of these will be rapid. The first part of the STP project, agreeing and approving the boundaries of the 44 footprint areas, was completed and published by NHS England, together with the names of the designated leaders in March 2016. The footprints (Figure 2) each include an average of 1.2 million people and 4.8 clinical commissioning groups (CCGs). Triple aim of the Five Year Forward View In the past, planning health and social care services has been undertaken in isolation. Within these new footprint areas, this ‘silo’ commissioning will be pushed aside in favour of more collaborative planning and management, namely ‘place-based planning’ for local populations. Although in the past, the NHS has emphasised an organisational separation and autonomy that does not make sense to staff or the patients and communities they serve, thoughts are now on encouraging shared visions for the local community (including local government), with local leaders coming together as a team. This may well be where we can focus neurology because, as a truly placebased plan, the STPs must cover all areas of CCGs and NHS England commissioned activity, including specialised services, where the planning will be led from the 10 collaborative commissioning hubs and primary medical care from a local CCG perspective, irrespective of delegation arrangements. The STP must also cover better integration with local authority services, including, but not limited to, prevention and social care, reflecting Sue Thomas