PowerPoint Presentation

Planning by place: How will Sustainability and Transformation Plans (STPs) help deliver the Five Year Forward View?Matthew Swindells, Director of Operations, NHS EnglandJulia Ross, Chief Executive North West Surrey CCG and STP SROSimon Enright, Director of Communications, NHS England

Sustainability & Transformation Plans (STPs)September 2016

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STPs will support the delivery of the Five Year Forward ViewUnderstanding and addressing the 3 gaps at a local levelHold underneath them a number of different specific plans to address local issuesNHS organisations retain their own accountability whilst working to a shared plan to collectively improve health, care and finance for their population44 STP footprints: organisations working together across health and care to deliver transformation and sustainabilityBreak down boundaries at the organisational level and unlock local energyDelivering the 5 Year Forward ViewUmbrella plan for changeMulti-year, place-based plans to meet local need

Why are STPs needed?

Current system tends to be driven by organisational annual plans Local and national leaders need to think beyond the boundaries of their own organisation, and over a longer timeframe find innovative solutions which meet local needs.Size of the challengeThis is significant change for the System and the transition process will not be straightforwardA one size fits all approach from the centre will not work. We must adopt a tailored approach.What are STPs?

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Background: The Five Year Forward View The NHS Five Year Forward View looks at the challenges we face leading up to 2020/21.

The challenges or three gaps - are:

For the NHS to meet the needs of future patients in a sustainable way, we need to close the three gaps in health, finance and quality of care by 2020/21.

Closing the three gaps locally: STPsThe NHS Shared Planning Guidance (December 2015) asked every health and care system to come together to create their own ambitious local blueprint for implementation of the 5YFVOne of the most powerful ways to achieve change is through local services working together. The Vanguards are already doing this.

NHS providers, CCGs, local authorities and other health and care services, have come together to form 44 footprints

These footprints will develop Sustainability and Transformation Plans (STPs) for 2016 - 2021, using the insight from the Vanguards but also with input from their own patients, people and communities to ensure they truly respond to local needs.

STPs provide an umbrella for key elements of the local system architecture

Transformation AreasSuccess RegimesNew Care ModelsPerformance plansDevolutionLocal Digital Roadmaps Statutory responsibilities for individual health and care organisations remainALB Regional Directors will retain accountability for delivery in their regionsExisting accountabilities for Chief Executives of provider organisations and Accountable Officers of CCGs are unchangedSTPs provide an opportunity to align the multiple aspects of system architectureIn some cases existing elements may be replaced by STPsExisting plans and frameworks may also continue in their own right but referenced and aligned through the STPBCF

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Understand key local issues Define early vision and prioritiesJulyDraft plans identifying 3-5 key decisions15 April checkpoint30 June checkpoint44 visits to Footprints234In July we held a face to face review with all 44 footprints to provide a checkpoint and review their draft plansIdentify and quantify opportunities and develop planCommunications to footprintsEngagement of staff and communities at every stageBuild the leadership Develop the vision and take early actionSTP review and implementation16 September5Finance template submissionsCollective leadership agreed1Establish common purposePlanning guidance published21 October6STP submissionsDecember onwards72-year planning round completeTransition into implementation

What STPs are not

More information

www.england.nhs.uk/stp

england.fiveyearview@nhs.net

Or join the conversation on Twitter using #FutureNHS

Introducing Surrey Heartlands STPjJulia RossChief Executive North West Surrey CCG and STP SRO

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Surrey Heartlands serves 850,000 people across 7 boroughs with combined health funding in 2016/17 of 1bn and combined social care and public health budget of 328m3 CCGs working through eight GP-led localities

684 GPs in 95 practices

H 4 acute hospital sites

H 11 community hospital sites

2 community services providers

1 mental health provider working from 4 in-patient sites and delivering community services from 22 sites

1 upper tier local authority (Surrey County Council) operating adult & childrens social services

7 District/Borough Councils

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Ageing populationExponentially growing demandHistorical lack of investment outside of the acute sectorSignificant workforce challengesStressed systemWe have some (familiar) challengesPut simply, the system is neither clinically nor financially sustainable for the long term

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and a vision that unites usAt the heart of our STP is a commitment to work together as a single system to transform public services and secure consistent, sustainable, high quality physical and mental health and care for the people of Surrey Heartlands for the long term

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ObjectivesAchieve consistent clinical pathways & remove unwarranted variationDeliver a system which is sustainable and designed to deliver quality, efficiency and access in careSecure buy-in for change and personal responsibility for health Speak with one voice and act with one mindCardiovascularCancerMental HealthMSKMaternity & ChildrenU&ECOther RightCare OpportunitiesHeartlands AcademyOut of Hospital StrategyAcute Operating ModelPrimary Care Operating ModelPrevention StrategyASC precept changeBack-office efficiencies Estates strategyFrom a standing start we have an ambitious and coherent plan, built and owned by the local systemGapsExisting financial pressuresDemand growth older, more complex patientsLack of integrated treatment approachesAcute sector already at full capacityDigital integration and innovationUnsustainable workforce model111m a year gap by 2020/21117m - 129m of efficiencies by 2020/21 supporting aggregate financial balance Citizen-led Health and Care approachSingle Control TotalInitiativesWorkforce ModelDigital

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But the real benefit goes beyond the plan

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Coalition of the willing with a commitment to honestyShared Local Authority and NHS leadershipWhole system in the room; multi-agency workingInternal resourcing with some additional supportCelebrate and build on existing local workNo tick box templates; an adult discussion amongst senior leadersA little bit of fairy dust.Our intention is to build the system so the system delivers

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Engaging widelyand going deepFrom intention to firm commitment to detail to deliveryEnsuring appropriate governance and oversightSecuring resources and building the delivery teamWe have a good first plan and are building a strong coalition, but theres much more to do

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Maintaining commitmentCollaborating across footprintsMaking sense of regulation and negotiating moving goalpostsResisting bureaucracyFinding resourcesTaking the right timeand we must address some on-going challenges

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So, the key question is, what will it take for STPs to be different, and more than just another planning cycle?

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Questions?