Sustainability and transformation plans: state of play and next steps for VCSE Matt Lloyd Head of Operations National

Announced in 2015/ /21 Shared Planning Guidance: –“ambitious local blueprint for accelerating its implementation of the Forward View…” Which should involve –“developing a shared vision with the local community, which also involves local government as appropriate” STPs so far

A new relationship? If we get this right, then together we will: engage patients, staff and communities from the start, developing priorities through the eyes of those who use and pay for the NHS - Guidance letter, February 2016

STP timeline AprilInitial submissions10 questions, 10 questions, including “How are you engaging patients, communities and NHS staff” MayAides-memoire published Includes “Supporting people to manage their own health, wellbeing and care”Supporting people to manage their own health, wellbeing and care JuneDraft plans submitted AugustAnalysis of plansSimon Stevens and Jim Mackie met with STP leads SeptemberNHS Planning Guidance NHS Planning Guidance published Includes ‘October guidance’ for STPs – ahead of submission dateOctober guidance OctoberDeadline for submission 21 st Must address feedback, financial template, metrics. Won’t be published until agreed NHSE/NHSI NovCore metrics releasedTo assess progress on finance, quality, and health outcomes and care redesign Oct-DecPlans taken to public boards Expectation published for more formal engagement

NHS Planning guidance 17/19 STPs play a central role in delivering the Five Year Forward View Focus on importance of working across organisations Each STP has financial control total, sum of individual control totals; some flexibility across organisations 1 2 3

NHS Planning guidance ‘Each STP becomes the route map for how the local NHS and its partners make a reality of the Five Year Forward View, within the Spending Review envelope. It provides the basis for operational planning and contracting.’

October Guidance System wide, locally agreed objectives How activity will flow between care settings What each organisation needs to do to deliver 1 2 3

Address earlier feedback Include “a crisp articulation of the tangible benefits to patients and communities”. Detail on how to implement proposed schemes Underpinned by finance template Include measureable impacts of the STP, reflecting local priorities e.g. CCGIAF, emergency admissions Brief statement on how envisaged better integration between health and social care could support overall STP objectives Degree of local consensus amongst organisations and plans for further engagement October Guidance

October guidance It would be useful to know the degree of support your proposals command, the extent that you have engaged stakeholders and the public so far, and your plans for further engagement with patients, stakeholders, clinicians, communities, staff and other partners…

Engaging local communities…

38% published analysis of templates and some STPs publically available Concern about ‘secret’ plans to ‘cut’ services Members report difficulties finding out what’s happening, though appears to be some local engagement happening STPs not expected to be published until finalised Engagement so far…

Engaging local people - guidance Aims to clarify expectations on patient and public participation To succeed, STPs will need to be developed with, and based upon the needs of local patients and communities “Effective communication and involvement throughout the process will help to build ownership and support for proposals to transform health and care and will also help identify potential areas of concern” Local proposals not expected to have gone for formal engagement or consultation at this ‘early stage’ Guidance intended to support STP process but does not replace each organisation’s legal duty to involve the public CCGs, local authorities, NHS trusts, NHS foundation trusts and NHS England have separate but similar obligations to consult  Encourage use of joint public involvement exercises, ensuring clarity about roles and responsibilities of each organisation

It is essential [to] have an ongoing dialogue with patients, volunteers, carers Engaging local people - guidance

Work with existing networks e.g. CCG lay members, VCSE networks, Healthwatch Local councillors can support engagement As proposals develop, STP partners can develop number of bespoke activities to work with local people, such as citizens’ panels

Widespread concern about lack of transparency about plans Difficult for VCSE to advise Raised by National Voices members in meeting with FYFV team Raised by several Strategic Partners 38 Degrees report and campaign FYFV team advised initial submissions would not be published STP plans won’t be published until signed off – though possibility NHS England may let local areas decide About 5 plans and many initial submissions have been published on CCG websites Transparency

Short timescales have made VCS engagement difficult Different areas started at different stages of working collaboratively on health and care STP timescales have been flexible in practice – building that in earlier could have supported engagement Need for NHSE to acknowledge the challenges being faced by local areas in meeting the engagement requirements Particularly challenging for local areas dealing with other policy change e.g. integration, devolution, cancer strategy Timescales

How can Strategic Partners and the wider VCS feed into the consultation phase once STPs are submitted? How can we engage with and support the implementation phase? VCSE offer for STP implementation

Thank