Changing the healthcare landscape one acronym at a time…

We often get told that the NHS seems to develop a new acronym virtually every week, well there’s an important one that is the focus of this blog which is STP.

STP stands for sustainability and transformation plan and each health and care system in the country is being asked to put one together. The request comes from NHS England who want the STP to support health and care systems to deliver the NHS Five Year Forward View that was published in October 2014.

One of the key elements of the Five Year Forward View is of a new health and care system that is place and population based. What does this mean? It means that we do away with some of our traditional organisation boundaries and work as one care team covering a local area or neighbourhood.

In west Leeds we’re already well underway with our planning for this and are looking to set up one of our first place based systems of care in the Armley area. This is also known as New Models of Care again part of the Five Year Forward View. Anyway I digress a little as this blog is all about the STP.

So the cynics among us may say that the STP is being used to shore up the finances of struggling hospitals.

And it’s easy to assume this as lots of health and care systems will be looking to support struggling care providers. But this is designed to go beyond that, it is designed to get system leaders thinking about how can we deliver sustainable change that really does transform services?

Matt Ward, Chief Operating Officer at NHS Leeds South and East CCG is coordinating this on behalf of all health and social partners in Leeds.

We’ve got a strong base to build from as health and care organisations in Leeds have been working together for some time. We’ve already been recognised for our pioneering way of delivering integrated care. This is being backed up by the roll out of the Leeds Care Record so we can remove some of the IT frustrations that can get in the way of frontline professionals looking to deliver the best possible care.

There’s no denying that the NHS and local authorities are facing severe financial pressures. We also have to be honest and admit that current forecasts for demand on services suggest things will only get tougher.

So we need to make sure we address some key issues in our STP and here are my 10 questions that need addressing.

  • What services need to adapt to changing technology over the next 10 years?

The way people expect to receive information and care is changing to reflect the technological advances in wider society. If people can book appointments and consultations with others over video conferencing why can’t they do the same with their healthcare professional? In a world where social media is now a big part of our life, why are health and care organisations not using this patient experience information to make changes to services?

  • What sort of providers will work across West Yorkshire and deliver services potentially on a hub and spoke model?

The guidance for developing a STP makes it clear that it’s not just organisational boundaries we need to remove, there’s also a need to move away from geographical boundaries. This means trying to work out how we can deliver critical services at scale while ensuring everyone has equal access to them.

  • What proportion of tertiary care will be delivered in West Yorkshire?

Linked to the above we need to decide what specialised services we deliver and where should they based. There are some things that we cannot deliver within a population/neighbourhood based system so we need to consider how they will fit in with the new health and care systems.

  • Do we need the same number of providers as we have now?

I can already hear a sharp intake of breath as I pose this question. Before I set hares running I want to make it clear we’re not talking about job cuts but more a change in who the employing bodies are. More importantly we’re looking at what future ‘total care teams’ will look like. If patients really are going to be the focal point of the new health and care system we need to work around them and not the other way around.

  • What priorities do the public have in relation to ensuring they receive care which adds value to their lives?

This is a simple and almost rhetorical question. We cannot just set up and deliver our STP without first drawing on the views of patients, carers and the wider public. We’ll need to draw on the existing evidence we have about what patients want and expect. But I feel there’s still a lot of work to be done, especially at neighbourhood level, to understand what people’s expectations are of health and care. We then have to manage those expectations as we simply can’t deliver all that will be expected.

  • How will we work as CCGs in the next 5 years and how will we collaborate significantly?

A very interesting question and one that I’m sure you’ll have your views on. I know that a lot of questions have been raised about there being three CCGs in Leeds and if this is effective. Many of you will know we’re already looking at how we can improve collaboration across the organisations and we’ll continue to do so. Will there be three CCGs or will there even be any CCGs in five years’ time….that’s probably another question for another day.

  • Do we need the same number of commissioners?

Similar to the question about CCGs we might need to consider how health and care is commissioned in the future. If there’s no organisational boundaries this might mean things that were traditionally commissioned by the NHS might be done by the local authority or may be undertaken jointly.

  • What changes need to occur to ensure we get best value out of everything we commission?

With budgets squeezed, demand continuing to grow and people living longer we need to really make sure we get the best out of every pound we invest in health and care. Our STP needs to look at how we can meet this challenge and continue to meet it in 10 years’ time.

  • What do we do next and how do we prioritise our work?

Once we’ve put together our STP we’ll have to decide what we tackle first. I’ve got some thoughts on this but actually I feel this is something we need everyone – patients, staff and the wider public – to help us with. So please do get in touch if you have any thoughts on this. Alternatively please keep an eye out for any engagement events we hold in the future.

  • How do we (health and care organisations) receive funding in the future?

If we’re losing organisational boundaries and looking at shifting where some of the commissioning decisions are made, we need to understand how money will flow through the system.

Lots of food for thought but also an opportunity to deliver real change that can deliver a system that is fit for the future. The STP is not just another acronym it’s one that could hold the key to the future of our NHS, locally and nationally.

Please do get in touch or leave your comments below if this blog has got you thinking about how we do things differently in the future.


Philomena Corrigan is the Chief Executive for NHS Leeds West Clinical Commissioning Group