How will Sustainability and Transformation Plans (STPs) help deliver the Five Year Forward View? Matthew Swindells and Simon Enright, NHS England, and Julia Ross, North West Surrey CCG Day One, Pop-up University 7, 10.00

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

2. Sustainability &
Transformation Plans (STPs)
September 2016

3. STPs will support the delivery of the
Five Year Forward View
• Understanding and addressing the 3 gaps at a local level
• Hold underneath them a number of different specific plans to address local issues
• NHS organisations retain their own accountability whilst working to a shared plan to
collectively improve health, care and finance for their population
• 44 STP ‘footprints’: organisations working together across health and care to deliver
transformation and sustainability
• Break down boundaries at the organisational level and unlock local energy
Delivering the 5 Year Forward
View
‘Umbrella’ plan for change
Multi-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 challenge
• This is significant change for the System and the transition process will not be straightforward
• A ‘one size fits all’ approach from the centre will not work. We must adopt a tailored approach.
WhatareSTPs?

4. 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.

5. Closing the three gaps locally:
STPs
The 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 5YFV
• One 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.

6. STPs provide an umbrella for key elements of the
local system architecture
Transformation Areas
Success Regimes
New Care Models
Performance plans
DevolutionLocal
Digital
Roadmaps
• Statutory responsibilities for individual
health and care organisations remain
• ALB Regional Directors will retain
accountability for delivery in their
regions
• Existing accountabilities for Chief
Executives of provider organisations and
Accountable Officers of CCGs are
unchanged
• STPs provide an opportunity to align the
multiple aspects of system architecture
• In some cases existing elements may be
replaced by STPs
• Existing plans and frameworks may also
continue in their own right but
referenced and aligned through the STP
BCF

7. Understand
key local
issues
Define early vision and priorities
July
Draft plans
identifying 3-
5 key
decisions
15 April
checkpoint
30 June
checkpoint 44 visits to
Footprints
2
3
4
In July we held a face to face review with all 44 footprints
to provide a checkpoint and review their draft plans
Identify and quantify opportunities and
develop plan
Communications to footprints
Engagement of staff and communities at every stage
Build the leadership Develop the vision and take early action
STP review and
implementation
16
September
5
Finance
template
submissions
Collective
leadership
agreed
1
Establish
common
purpose
Planning guidance
published
21 October
6
STP
submissions
December
onwards
7
2-year planning
round complete
Transition into
implementation

8. What STPs are not…
STPs won’t necessarily
replace existing plans
to improve services in
an area. They are an
umbrella plan for
change.
Being part of an STP
footprint does not
mean that NHS
organisations will
have to lose their own
autonomy or identity.
But it does mean that
organisations will be
working to a shared,
agreed plan.
STP footprints are not
new, statutory
organisations.

9. More information…
www.england.nhs.uk/stp
england.fiveyearview@nhs.net
Or join the conversation on Twitter using #FutureNHS

10. Introducing Surrey Heartlands STP
j
Julia Ross
Chief Executive North West Surrey CCG and STP SRO

11. 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 £328m
• 3 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 & children’s social services
• 7 District/Borough Councils
3

12. • Ageing population
• Exponentially growing demand
• Historical lack of investment outside of the acute sector
• Significant workforce challenges
• Stressed system
We have some (familiar) challenges…
Put simply, the system is neither clinically nor financially
sustainable for the long term

13. …and a vision that unites us
At 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

14. OBJECTIVES
Achieve consistent clinical
pathways & remove
unwarranted variation
Deliver a system which is
sustainable and designed to
deliver quality, efficiency and
access in care
Secure buy-in for
change and personal
responsibility for health
Speak with one voice
and act with one mind
Cardiovascular
Cancer
Mental Health
MSK
Maternity & Children
U&EC
Other RightCare Opportunities
Heartlands Academy Out of Hospital Strategy
Acute Operating Model
Primary Care Operating Model
Prevention Strategy
ASC precept change
Back-office efficiencies
Estates strategy
From a standing start we have an ambitious and coherent plan,
built and owned by the local system
GAPS
• Existing financial pressures
• Demand growth – older, more complex patients
• Lack of integrated treatment approaches
• Acute sector already at full capacity
• Digital integration and innovation
• Unsustainable workforce model
• £111m a year gap by 2020/21
£117m - £129m of efficiencies by 2020/21 supporting aggregate financial balance
Citizen-led Health and
Care approach
Single Control Total
INITIATIVES
Workforce Model Digital

15. But the real benefit goes beyond the plan…

17. • Coalition of the willing with a commitment to honesty
• Shared Local Authority and NHS leadership
• Whole system in the room; multi-agency working
• Internal resourcing with some additional support
• Celebrate and build on existing local work
• No tick box templates; an adult discussion amongst
senior leaders
• A little bit of fairy dust….
Our intention is to build the system
so the system delivers…

18. • Engaging widely…
– …and going deep
• From intention to firm commitment to detail to delivery
• Ensuring appropriate governance and oversight
• Securing resources and building the delivery team
We have a good first plan and are
building a strong coalition, but there’s
much more to do…

19. • Maintaining commitment
• Collaborating across footprints
• Making sense of regulation and negotiating moving goalposts
• Resisting bureaucracy
• Finding resources
• Taking the right time
…and we must address some on-going
challenges

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

21. Questions…?