National health and care bodies in England have published details of the 44 ‘footprint’ areas that will bring local health and care leaders, organisations and communities together to develop local blueprints for improved health, care and finances over the next five years, delivering the NHS Five Year Forward View.
Senior leaders who will be leading this work have also been confirmed. Recognising the need for local systems to work in partnership, there is broadly equal representation from clinical commissioning groups and from hospitals and other providers of care, as well as some key figures from local authorities.
Last December, NHS shared planning guidance set out a new approach to help ensure that health and care services are planned by place rather than solely around individual institutions, over a period of five years, rather than just a single year. Central to this are the design and delivery of Sustainability and Transformation Plans (STPs), which must show clearly how each area will pursue the ‘triple aim’ set out in the NHS Five Year Forward View – improved health and wellbeing, transformed quality of care delivery, and sustainable finances.
Frontline leaders have worked together closely to agree the most locally appropriate boundaries, recognising that footprints will not cover all planning eventualities, and that different areas will have different needs. Populations range from 300,000 (in West, North and East Cumbria) to nearly three million people (in Greater Manchester). They include five local areas within London, and many which are in line with county boundaries.
NHS England worked to establish a Sustainability and Transformation Fund of £2.1bn for 2016/17, which will rise to £2.9bn in 2017/18 and to £3.4bn in 2020/21. STPs will become the single application and approval process for being accepted onto programmes with transformation funding from 2017/18 onwards.
Most of the 44 areas will be led by people already working in the local health and care economies, with named individuals responsible for convening, overseeing and coordinating their STP work. They are individuals who command both local and national support, whose collective efforts alongside colleagues will help transform health and care over the next few years.
The national bodies are also publishing guidance and templates to support areas in submitting information about their governance and priorities by 15 April, in advance of final submissions by the end of June.
Simon Stevens, Chief Executive of NHS England, says: “Now is quite obviously the time to confront – not duck – the big local choices needed to improve health and care across England over the next five years, and STPs are a way of doing this. Their success will largely depend on the extent to which local leaders and communities now come together to tackle deep-seated and long-standing challenges that require shared cross-organisational action. The NHS nationally will be working closely to support them in doing that.”
Jim Mackey, Chief Executive Designate of NHS Improvement, adds: “Everyone accepts that change is needed within the NHS. We need to create a health and care system that meets the needs of patients and is sustainable for the long-term.
“Improvement within the NHS needs organisations to work strategically within their local health economy. We need the Sustainability and Transformation Plans to encourage
organisations to work together, to think boldly and to work out how change – no matter how radical – can best be achieved to meet the major challenges we face.
“NHS Improvement will continue to support these local areas as they look to deliver the improvements we all want to see.”
