No-one now doubts that these plans will have an important impact upon the ability of the NHS to meet the challenges of its Five Year Plan.

But as our selected quotations from last Wednesday’s Parliamentary debate revealed, there is still much confusion about the process and in particular about the level of involvement that local people can expect as the STPs are developed.

Ministers made it clear that they expect a high level of engagement, although MPs have argued that there is little evidence of this to date.

NHS England published its Guide Engaging local people the following day and reiterated the need for engagement and consultation.

This Guide provides helpful advice but the real question is whether STP planners have the resources, the time and the capacity to engage as professionally as they might wish. Are there Footprints where leaders may – in their June submissions – have gone further in developing plans than perhaps was wise if there had been insufficient involvement of local authorities and other key stakeholders?

The Institute agrees with NHS England that there is not a one-size-fits-all blueprint for the engagement and consultation that should now take place. Each area needs its own plan, and we think the precise shape of such plans should take account of the following:

• How established is the ‘Footprint’ as a planning entity. If the key organisations are thoroughly familiar with working with each other and if Footprint-wide consultative mechanisms already exist, it makes for an easier dialogue framework
• How radical an agenda for change may be emerging in the Footprint. We recognise that if there are few controversial aspects to local plans, it may not warrant the same intensity of involvement as areas where there are highly contentious issues.
• The level of local awareness and concern. The views of Members of Parliament, Local Authority ‘leads’ and other sources should help STP leaders identify local expectations for dialogue and participation
• The local consultative culture. This varies along with the socio-economic and political geography of the nation, and the history of public and patient involvement can influence the degree of public participation on public services

None of these factors will affect the statutory responsibilities of each STP and its constituent participants. These are well set out in Annex A of the Guide.

However, another legal issue is the growing relevance of the ‘doctrine of legitimate expectation’. One of the ways this can work is to make it very difficult for NHS Mangers and local authority leaders to ignore advice issued in the NHS England Guidance. The default position is that, unless there are excellent local reasons to think otherwise, the public can expect that the provisions of the Guidance will apply.

The Institute expects that its Health and Local Government specialist Associates will now work with STP Communications leads to help them interpret and apply these Guidance provisions. We have already developed a slidedeck that will be used on these assignments. Here are a few of the slides they will use, so you have a flavour of the messages that will be covered ….