Sustainability and transformation plans

Sustainability and Transformation Plans (STPs) are area-based five-year plans for health and care services in England


The plans bring together NHS providers, Clinical Commissioning Groups (CCGs), local authorities and other health and care services. You can find out more about what STPs are and which ‘footprint’ your area falls in to by visiting the NHS England website.

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Why are they important to me?

The 44 STP ‘footprint’ areas look set to be the key mechanism for shaping future health and care services. They will cover whether investment in primary care will include physiotherapy and the future of rehabilitation services.

What’s the CSP’s view so far?

The CSP agrees that changes to the current health and care system are necessary. We support a move to a more preventative and rehabilitative system. We also support the idea of collaboration across local systems e.g. NHS trusts and local authorities, and the integration of health and social care as a means to improve patient care. We opposed the further splitting of commissioning and providers in 2012 and welcome moves to a more collaborative approach. However, transforming the health and care system requires time, investment and engagement with both the workforce and the wider public.

Claire Sullivan, CSP Director of Employment Relations said:

"STPs have the potential to be a force for good, helping us to integrate and co-ordinate hugely complex local health and care systems. We are seeing some of the early benefits of this type of joint work in Greater Manchester.

However, the central issue of funding cannot be dodged - no system, however good, can be the whole answer if funding is inadequate. And the case for engagement is clear - better engagement, particularly with the people delivering services, results in better outcomes."

STPs need to be opened up to public scrutiny if they are to challenge the perception that STPs are a vehicle to cut costs and rationalise provision. Lessons can be learnt about workforce engagement from the devolution process in Greater Manchester. There the CSP has worked successfully with other trade unions to ensure that engagement with unions is built into the structure of health and care planning.

I’ve heard a lot of negative things in the press, why is that?

STPs have been surrounded by controversy in the media so far, with timelines appearing rushed and somewhat unclear. They were initially announced in NHS planning guidance in December 2015, with plans expected to be operational in October 2016; however, we are only now seeing the majority of the plans being made available online.  All 44 plans are expected to be published by the end of the year. From April 2017 STPs will be the single channel for accessing transformation funding, replacing the vanguard programme.

Opposition to STPs has in the main been driven by concerns about funding and lack of engagement. A range of groups including GPs and local authorities have expressed concerns about this and also that the STPs focus is dominated by hospitals. The lack of funding across health and social care has also meant that there appears to be a focus on short term savings rather than transformational change.

What do you want me to do?

  • Find out if the plan for your area has been published and what it is proposing. You will have to Google this as the plans aren’t stored on a central website.
  • What are the priorities within the plan? 
  • Do they offer opportunities or threats to physiotherapy services? E.g. more primary care/community ‘hubs’.
  • Is there any information about how to get involved in engagement/consultation processes? Is trade union involvement mentioned? Are there any timelines for this process?

You can feedback to Stewards and English Regional Networks to work together locally on this important issue, or contact Alice Sorby, Policy and Research Officer.

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