Kate Laycock, Researcher at Reform, wrote an article in Conservative Home following the launch of Reform's report, Saving STPs. Achieving meaningful health and social care reform. The idea of Sustainability and Transformation Plans (STPs) is a good one, aiming to tackle issues including the division between health and social care, within the NHS itself and to overcome a “fortress mentality” in the NHS. However, the plan is not going to deliver in its current form.
The involvement of local authorities has been minimal and the plans will need the support of local NHS staff and voters, many of whom weren't aware of the process or consulted. Perhaps most importantly, STPs cannot solve the underlying reasons for the NHS's current problems such as the perverse funding arrangements. Instead, Ministers will need to have strength in their convictions to make STPs work. This would involve giving STPs control of the NHS and social care budgets; setting up desired health outcomes for their populations and hold providers to account; creating a directly elected individual responsible for the NHS budget such as a new Health Care Comissioner or a metro mayor; and clarifying existing legislation on competition.
"Ministers may object that these far-reaching recommendations amount to the kind of “structural reorganisation” which went wrong under the Coalition Government. What STPs have revealed, however, is that true NHS reform cannot be delivered by well-intentioned conversations alone. The devolution of health and social care to Manchester, also achieved under the Coalition, shows that the right kind of changes can be made without upheaval or even controversy."
Read the full article here.