I’m still head scratching over the significance of Philip Hammond’s £325m announcement for Sustainability & Transformation Plans in England.

On the one hand, every little helps. On the other hand, the ‘Transformation’ part of the equation was always going to need lots of capital expenditure etc., and rumour holds that funding current NHS deficits has eaten massively into the money that Simon Stevens had provisioned for this in his original calculations.

It’s probably wise to look at this alongside last week’s announcement of a new ‘patient care test’ by which NHS England will judge STP plans. Also, look carefully at the words that accompany the £100m earmarked for A&E. In all these I see signs that they are trying to pick winners – proposals that can genuinely make a difference.

But there is another way to pick winners – and that is to discover which proposals can convince local communities. The trouble with some set-piece public consultations is that they focus exclusively on bad news; site closures, service withdrawals or downgrading. Anyone who has examined draft STPs know that there is much that is positive and extremely beneficial, and the test of public and patient involvement henceforth should be whether they equip stakeholders with a balanced view of the pros and the cons of key proposals. If this modest cash injection helps lubricate the change process for those plans that really will improve local health outcomes, then that’s good.

But there must be robust, best practice consultation with local people. That’s what the politicians have promised, and that’s what the Managers must deliver.