Sustainability and transformation plans

NHS organisations across England are currently working together to produce sustainability and transformation plans (STPs).

What are sustainability and transformation plans?

Sustainability and transformation plans (STPs) are five-year local plans for health and care services. They are being developed by 44 geographical areas, or ‘footprints’, covering England. NHS organisations, local authorities and other health and care services within these footprints must develop these plans together.

What’s the issue?

STPs were due to be submitted to NHS England by the end of October this year – with plans to be finalised by the end of 2016.

STPs will shape health and care services across England for the next five years, so it’s essential that patients, the public and staff are fully involved in their development. So far, there has been little consultation or engagement about the plans.

In theory STPs have the potential to encourage closer working between health and social care services. They are also intended to bring commissioners and providers together and to encourage collaboration between providers.

But, STPs are also expected to indicate how they will make billions of pounds of efficiency savings by 2020 through service reconfigurations and system changes. The concern is that this level of saving cannot be achieved through greater integration. This means that savings may need to be found through cuts to services or to staff pay, terms and conditions.

What is UNISON calling for?

The key thing the NHS and care services need is extra money. It is clear that the NHS is close to collapse and that there is a funding crisis in social care. UNISON is calling on the government to provide an urgent funding boost and to ease the pressure for unrealistic efficiency savings. 

UNISON, along with other NHS trade unions, has written to the Secretary of State to ask that the STP process is slowed down. This will give patients, staff and the public greater confidence that local decisions are being made for the right reasons, rather than as part of a rush to make savings.

For such far-reaching plans to work they must have buy-in from patients and the local community. UNISON is calling for meaningful public engagement around STPs at the earliest possible stage, including full and accessible publication of the plans.

STPs should also be subject to scrutiny from local authority bodies such as Health Overview and Scrutiny Committees and Health and Wellbeing Boards. UNISON is calling for support for local authority scrutiny bodies in carrying out their governance and oversight roles as a means of holding STPs to account.

STPs have the potential to cause much uncertainty and disruption for staff working in the NHS at a time when morale is already very low. UNISON is calling for proper staff and trade union engagement in the development of the plans, along with reassurances from the government around security of employment and pay, terms and conditions.

We have raised these concerns with MPs across England and will continue to raise our concerns at the highest level.