Reform submission: Health Select Committee inquiry on “Sustainability and Transformation Partnerships”

NHS England has ambitious plans to reform healthcare. It wants to deliver more care in the community, in a timelier and more effective manner for patients. Key vehicles for achieving this are Sustainability and Transformation Partnerships (STPs), which are designed to bring together healthcare commissioners to coordinate local care plans.

The principle of commissioning healthcare across care pathways, taking into account GPs, hospitals and other providers, is sound: it incentivises care to be delivered in the most effective place, thereby improving outcomes and reducing cost.

STPs will not achieve this within the current NHS framework. STPs have no power to commission health contracts, which currently incentivise care delivered in hospitals. STPs have not worked closely enough with local government to identify public-health and social-care needs. STPs are a sticking plaster for a complex commissioning framework, including NHS England, Clinical Commissioning Groups, local authorities, and Health and Wellbeing Boards.

A simpler framework is needed which can commission care from one organisation. Devolution areas offer one model, with directly elected mayor sitting atop combined authorities. Those bodies could take control of healthcare commissioning. This will require legislative change and public engagement to deliver, but offers a route to achieving NHS England’s ambitious plans.