Rhion Jones has been reading Simon Stevens’ long-awaited update to the NHS Five Year Plan in England. He finds some interesting harbingers of what’s ahead in an admittedly challenging environment.

Whilst much sound and fury has raged over the apparent failure of NHS bodies to engage fully with Councils and the voluntary sectors over Sustainability & Transformation Plans (STPs), this Report clearly shows that there has been much progress across a whole range of issues since the Five Year Forward View back in 2014.

For public engagement professionals, here are our interim observations – more next week.

The Good news is a clear commitment to community participation and involvement

• STPs will become Sustainability & Transformation Partnerships!
• One of their roles is to be “a forum in which health leaders can plan services that are safer and more effective because they link together hospitals so that staff and expertise are shared between them.”
• Then it adds “More fundamentally, they require engaging with communities and patients in new ways.” And talks of ‘collective action’ on service design.
• STPs will have a basic governance and ‘support chassis’ (!!!) and appoint or reappoint STP chairs/leaders using a ‘fair process’.
• Programme management support for STPs and maybe some tweaking of the geographical boundaries of the 44 ‘footprints’ – a word that seems happily to be disappearing from the documents.
• A clear-cut acknowledgement that there will be “major changes in local services that require formal public consultation.” And a sensible admission that “All of them require local engagement with patients, communities and staff.”
• Special mention of the new 5^th Test for proposed reconfigurations proceeding to consultation. Discourages bed closure proposals unless adequate safeguards are in place.

Bad News may be a little strong, so let’s call it Less Good News

• New jargon – population-based integrated health system may become important!
• A new (non-statutory) organisational hybrid called Accountable Care Systems will be experimented upon in some of the nine named STP areas of the Report.
• They may well be a brilliant idea, but, at first glance, seem destined to cause confusion because of blurring the responsibilities of existing statutory bodies; local people may well struggle to know who should be in dialogue with whom.
• Less strategic but important changes to Primary Care need much better routine public engagement and there is little sign that the NHS is providing the resources to assist in this. It just hopes change will successfully happen. Not without first-class engagement it won’t!!