NHS England has divided the country in 44 ‘footprint’ areas, generally following local boundaries as much as possible, to formulate Sustainability and Transformation Plans (STPs) for their local populations. The remit is to deliver the NHS Five Year Forward Review which calls for radical changes in the NHS. Local health and care leaders, organisations and communities are working together to improve health, care and finances within the NHS. The STPs give opportunities to improve care provision whilst dealing with the added pressures on services due to the increased life expectancy, the rising number of ailments associated with old age and the increase in numbers of people living with chronic and long term conditions.
Health and care services will be planned by place rather than individual institutions, and over a five year period rather than annual reviews. Engagement with patients, staff, communities and local stakeholders is vital. Effort to engage with clinicians and other staff is paramount. Each area will pursue the ‘triple aim’ set out in the NHS Five Year Forward View, namely
- Improved health and wellbeing for their population
- Transformed quality of care delivery
- Sustainable finances
NHS and local council leaders who have already been working in their local health and care economies are working together on the proposals in each ‘footprint’ area. Areas will obviously vary in their local needs. The national bodies are also publishing guidance and priorities.
The average number of CCGs per ‘footprint’ is 4.8 (range 3.6 – 7.4), and the average population served is 1.2 million (range 1 to 1.7 million). There are 9 areas in the North, 17 in the Midlands and East, 5 in London and 13 in the South of England.
Funding for the STPs has been set at £2.1bn for 2016/17, ££2.9bn for 2017/18 and increasing to £3.4 bn for 2020/21. STPs will be the single application and approval process for being accepted onto programmes with transformation funding.
There are fourteen areas which are top line objectives and changes/improvements to service delivery need to be collaboratively achieved by the end of this decade. Six of these (which will probably have the greatest impact on Dietitians) include cancer, diabetes, maternity, prevention, primary care, and urgent care & 7 day hospital services.
STPs will be supported by the six national healthcare bodies – NHS England, NHS Improvement, the Care Quality Commission (CQC), Health Education England (HEE), Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE).
Dietitians are actively encouraged to be involved in their local consultations as much as possible and influence future changes. There is a large amount of information relating to STPs accessible on the NHS England website.