Three reflections on the day that 44 NHS ‘footprint’ areas in England submit plans for the future of Health and Social Care.

1. It has been an ambitious process

Critics have seen a range of ‘conspiracy theories’ at work, but in strict process terms, the idea of involving a much wider range or organisations, institutions and local stakeholders in NHS planning is thoroughly laudable. Local Authorities are leading some of these Footprints, although it is a little early to know how successful this has been. They cannot do much without full access to a lot of NHS financial and operational data, so information sharing is essential.

2. The goal of consensus is a worthy one

The public’s relationship with the NHS is quite unique and it is passionately engaged about perceived threats to cherished services. Members of Parliament also know they are vulnerable to electoral swings if local changes become really contentious. Remember how local surgeon Richard Taylor twice won Wyre Forest following the closure of an Accident & Emergency Service in Kidderminster. Avoiding the NHS becoming a local political football is important – especially for community cohesion. Achieving a high degree of consensus is a desirable objective.

3. Retaining local goodwill is now a challenge

Now here’s the difficult bit.

Whatever engagement has occurred so far (and clearly some areas have struggled to do enough – and have been criticised for it), there will now be pressure for early publication. NHS England has floated the idea of a public-facing Summary, and it is possible that this will be acceptable to some local stakeholders. Our fear is that MPs and the media will be expecting rather more. The Minister has said “When the STPs come back in October after being signed off, they will be consulted on.”  What form this ‘consultation’ takes is unclear, but every STP Footprint how has to develop an approach that will meet this requirement. Key stakeholders will certainly be asking what is intended.

To help with this, the Institute can provide an independent view of what might work well. We already have a methodology to assess the extent of engagement undertaken so far – as this is obviously the starting point for forward planning. But our Associates also bring a wealth of practical expertise to complement the local know-how of people who are in-situ. It is not a skills issue as much as a lack of capacity! Bear in mind also that, at some point the current ‘engagement’ will change into a formal ‘consultation’ where strict legal rules apply. Mistakes made in the engagement that takes place now can have a serious impact if your subsequent decisions are challenged in Court.

Our role in the Institute is to guide our members and clients towards best practice so that it minimises the risk of legal, political or media challenge.

The STPs have already attracted criticism, so we encourage everyone to handle them with great care and to build for their future consideration and possible implementation on the basis of meaningful dialogue.

For further discussions, speak to Institute Associates with NHS involvement. They include Nick Duffin, Fraser Henderson, Paul Parsons, Jonathan Bradley, Brian Parry, Amanda Murrell, Andy Mills, Jackie Robinson and others.

Or call the Centre of Excellence in Bedfordshire on 01767 318350.