Sustainability and transformation plans for the NHS in England: radical or wishful thinking?

Planning is back in fashion in the NHS. Over the past 15 months, NHS England has overseen the production of sustainability and transformation plans (STPs) for health and care services in 44 geographical areas or “footprints” covering the whole country.1 They have been produced by local NHS organisations, with varying levels of involvement from local authorities, senior clinicians, professional associations, patient groups, and the public. The King’s Fund think tank has described how they have been produced2 and analysed the content of all 44 STPs.3

We have had almost three decades of health reforms in the English NHS emphasising competition and markets, patient choice, provider autonomy, and the like.4 A journey that started in the early 1990s with Kenneth Clarke’s introduction of NHS trusts, GP fundholding, and the internal market concluded with Andrew Lansley’s abolition of strategic health authorities, primary care trusts, and much of the organisational infrastructure of the NHS, just leaving clinical commissioning groups, NHS and …