The first ratings for STPs were published on 21 July and followed close on the heels of the announcement that an additional £325m was being invested in the ‘strongest performing’ STPs. Both help to clarify what STP attributes are highly rated and what ‘strong performance’ looks like, a clarity that attendees at our roundtable event thought was missing.
Since their announcement, different parts of government and the NHS have voiced slightly different aims for STPs:
- the Treasury looks to STPs to support financial control;
- the Department of Health hopes STPs will deliver improvements in patient care within a constrained resource envelope;
- NHS England looks to STPs to support the delivery of its five year forward view; and
- NHS Improvement looks to STPs to help remove inefficiencies on the provider-side.
Now, in the combination of ratings and identification of the ‘strongest performing’ STPs, there is at least some clarity in what central NHS bodies consider to be the key aims of STPs.
Key indicators chosen for the ratings include:
- hospital performance on emergency and elective treatments and safety issues;
- patient focussed performance on extended GP access, mental health and cancer treatments; and
- performance on preventative measures such as emergency admissions, bed occupancy and DTOC.
Our roundtable audience felt that there must be much stronger recognition within STPs themselves that their work will, and indeed must, benefit patients. They felt that, not only did this have obvious benefits for patients, but that when the patient interest is not placed front-and-centre of STPs’ decisions, it is easier for constituent organisations to lapse back into individual self-interest.
The key indicators help to provide this focus on the ability of – and expectation on – STPs to make improvements in aspects of patient care. However, it is clear that though some are making good progress, others face differing challenges. For some STPs, the greatest challenge lies in the configuration of their health economy; for others (particularly in the most deprived areas) it lies in the complexity of their caseloads.
It will be increasingly important over the coming months to ensure all STPs receive support and advice to organise their governance structures in the right way to focus their decision making on patient benefits. It is hoped that this will go some way to enable them to achieve not only their own local ambitions but also the underlying ambition of all STPs; delivering improvements in population-wide health and social care