News & Insights

tCI’s views on the King’s Fund STP report

Rhion Jones has been studying yesterday’s Report from the King’s Fund. “Sustainability and Transformation plans in the NHS – how they are being developed in practice?”. Here is the Institute commentary.

This is the most comprehensive analysis of the STP process so far. It is an excellent piece of work and should be a ‘must read’ for all those involved. Critics of the process will find plenty of ammunition – but there is also considerable insight into the forces that obliges NHS England to make good the clear deficiency of the Health & Social Care Act in terms of planning for a more integrated service in the future.

In the Institute’s view:-

  1. Criticism of progress so far centres around the organisation of STPs rather than the content. However, the King’s Fund bases its Report on detailed interviews with four contrasting STPs. We do not know how representative these are, so we must be cautious in extrapolating too much from this small sample.
  2. Of its 10 recommendations, the top two echo the Institute’s anecdotal evidence. They are:
    1. Involvement in the STP process should be strengthened at all levels within the health and care system, particularly among clinicians, frontline staff and local authorities
    2. Meaningful involvement of patients and the public has not happened so far and must now be a priority
  3. The Report explains that this was partly because of tight timescales ‘and partly because national NHS bodies had asked leaders to keep their draft STPs out of the public domain.’ However, since the King’s Fund conducted its interviews in the summer, much has happened. New drafts of STPs were submitted in late October, and despite the policy of confidentiality over a dozen have been published in part or in full. There is therefore little to stop STPs from intensifying its local, public and patient engagement.
  4. We think the King’s Fund has sidestepped the issue of whether there should be formal consultation on the STPs themselves. Everyone agrees that there will be consultation on specific service change proposals – and that is challenge enough for many areas. But there is a case for taking the overall plan to the local community and seeking its endorsement for the key strategic approach. It also helps democratically-accountable local authorities remain on board with difficult decisions. The Institute expects growing pressure from Parliamentarians and others to hold Ministers to their commitments that there would be such consultation.
  5. In the meantime, we believe that the King’s Fund Report highlights how vulnerable the process might be to criticism and how implementation of key service changes may be compromised by a lack of engagement. Our view is that every STP should now take stock of the involvement undertaken so far, and draw up plans for greater and better engagement and consultation so as to restore public confidence and assist quicker and implementation of those schemes that command sufficient stakeholder support.

The Consultation Institute expects to work with a number of STP ‘footprints’ to provide specialist cost-effective Advice and Guidance and to offer a measure of external independent quality assurance for the public engagement plans that are now being prepared.

https://www.youtube.com/watch?v=__pG3QYXNXE

For information on this and other Institute services, please contact Rhidian Jones on 01767 318350 or email rhidianj@consultationinstitute.org

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