Sustainability and transformation plans: a troubled start

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i6064 (Published 15 November 2016) Cite this as: BMJ 2016;355:i6064
  1. Nick Black, professor of health services research,
  2. Nicholas Mays, professor of health policy
  1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
  1. Correspondence to: N Mays Nicholas.Mays{at}lshtm.ac.uk

These plans can work despite the challenges if we make the right changes now

Ever since 1948 the NHS in England has needed an intermediate tier between the national and the local to plan and govern services. So, it is no surprise that three years after the 2012 Health and Social Care Act removed strategic health authorities, NHS England reintroduced regional governance in the form of sustainability and transformation plans (STPs). The need for coherent planning has been heightened by the act’s fragmentation of the system and exacerbated by the current extraordinary financial constraints and rising demand.

STPs are a way of introducing regional planning without formal reorganisation, a workaround designed to avoid the cost of creating an intermediate tier and legislative changes. NHS England recognises that successful transformation of health and social care, envisaged in the Five Year Forward View,1 is unlikely without regional leadership driving change. STPs are to bring together NHS commissioners and providers with local government, and to inject greater collective urgency into …

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