The play-acting phase seems to be over and most of NHS England’s STP ‘footprints’ have made their draft plans publicly available in one form or another. They are a mixed bag, and, happily, some are clearly the product of both the clinical and the municipal mind.

But there are other parts of the country where peace and harmony is in short supply and where Councils are wary, if not downright hostile to the STP process. Some of this may be a question of who exactly has been involved. Who spoke on behalf of the Council?

No Council wants to be a willing accomplice in closing cherished NHS services, but any examination of most STPs will find plenty of positive initiatives –innovations that amount to significant service improvements. Head-in-the-sand opposition only delays the effective implementation of the good stuff, without any guarantee that the unpopular steps will be forever cancelled. That is why the case for joint planning of the health and social care system is desirable; it is also inevitable.

The local authority complaint is that the STP process was too fast and frenetic to allow proper engagement. Because of the embargo on publishing papers and proposals, officers and Councillors frankly sometimes didn’t know to what exactly they had committed themselves. Hesitation follows. Much easier to explain to suspicious constituents that it was ‘Not me, Guv’nor’.  But where Councils need to develop and deliver new community-based services, and that’s almost everywhere – they might as well just get on and do it.

Except for one thing. The public is no longer keen on public bodies – no matter how prestigious – huddling in a corner and taking decisions that impact upon communities. They demand a voice, or at least that someone on their behalf speaks for them. That’s what the commitment to “public and patient involvement” is all about.

As it happens, many parts of the NHS have made good progress since the 2012 reorganisation and built good local relationships and some effective machinery for dialogue. Where the “footprint” areas are congruent with such arrangements, the STP dialogues should be straightforward, and Councils have little excuse for stepping back. Where these advantages don’t apply and where local rivalries make it difficult for elected Councils to co-operate, someone needs to break the logjam.

So here is an idea from the Consultation Institute. As a not-for-profit, totally independent best practice body with huge experience of NHS and local authority public consultations, we have the capability to examine the level of engagement within your organisation. We can cost-effectively advise Councils and NHS Managers on the kind of engagement that would satisfy the conflicting requirements of NHS England, Ministerial commitments to consult and, of course, the Courts. Whilst the Institute is already planning to help some of the NHS ‘footprints’, maybe there is also a case for Councils that have been disappointed in the STP dialogue to date also to approach the Institute to see if we can encourage better engagement. Worth a try?