Sustainability and Transformation Plans Webinar for voluntary and community sector/social enterprise partners 30 January 2017

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Background: The Five Year Forward View The NHS Five Year Forward View, published in October 2014, considers the progress made in improving health and care services in recent years and the challenges that we face leading up to 2020/21. These challenges include: the quality of care that people receive can be variable preventable illness is common growing demands on the NHS means that local health and care organisations are facing financial pressure the needs and expectations of the public are changing. New treatments options are emerging, and we rightly expect better care closer to home.   There is broad agreement that in order to create a better future for the NHS, all those with a stake in health and care must make changes to how we live, how we access care, and how care is delivered. This doesn’t mean doing less for patients or reducing the quality of care provided. It means more preventative care; finding new ways to meet people’s needs; and identifying ways to do things more efficiently. For the NHS to meet the needs of future patients in a sustainable way, we need to close the gaps in health, finance and quality of care between where we are now and where we need to be in 2020/21.

The Five Year Forward View Delivering the Forward View locally: STPs For the NHS to meet patients’ needs better in future, we need to close all three gaps set out in the Forward View. To do this, every part of the NHS needs to understand: local priorities and challenges related to the three gaps how these are likely to evolve over the next five years

Delivering the Forward View locally: STPs The NHS Shared Planning Guidance (December 2015) asked every health and care system to come together to create its own ambitious local blueprint for accelerating implementation of the Forward View Sustainability and Transformation Plans (STPs) are place-based, multi-year plans built around the needs of local populations. All are now publicly available. STPs will: drive genuine and sustainable transformation in patient experience and health outcomes over the longer term; be delivered by local health and care systems or ‘footprints’: organisations working together to plan around the needs of whole areas, not just those of individual organisations. not be an end in themselves, but a means to build and strengthen local relationships, and to develop shared understanding of where every area is now, its ambitions by 2020/21 and concrete steps needed to meet these.

44 ‘footprint’ areas are leading the STP work Each led by a senior figure: charged with convening key players in the local health and care system directly connected to national leadership and support supported locally by a programme director and dedicated resources Leaders are drawn from different parts of the health and care system: 20 trust chief executives (hospitals and mental health trusts) 18 CCG leaders including some who are GPs 4 local authority leaders 1 success regime chair

What does all of this mean for patients, carers and service users? There are big opportunities to improve care by making common-sense changes to how the NHS works. These include ideas like making it easier to see a GP, speeding up cancer diagnosis and offering help faster to people with mental ill-health. Examples of local proposals to benefit patients include: In Surrey, a £30 million investment in primary care services is proposed, giving people more access to GP appointments in the evenings and at weekends, and longer appointment times where necessary. In Somerset, simple changes to the way care services work will reduce the number of people stuck in a hospital bed when they do not need to be, recognising that most patients in hospital today are frail, needing social support as much as medical. In South East London, the NHS wants to develop a £30 million cancer centre at Queen Mary’s Sidcup to complement the new £160 million purpose-built centre at Guy’s Hospital, providing an additional 16,000 radiotherapy and 4,600 chemotherapy treatments a year from early 2017. STPs were never designed to answer every question facing local health and care services. But they have been important in getting the right groups of people to think about what fundamental changes are needed locally.

STPs now embedded in 2017-2019 NHS planning round NHS Operational Planning Guidance for 2017-2019 built around STPs Help STP commitments and changes translate fully into individual organisations’ operational plans and contracts STP areas enabled to apply for their own system-wide financial control totals: to support collaboration, allow resource-pooling, make it easier to use money to support care improvement and redesign.

Setting expectations on working with local patients, communities and the voluntary sector http://www.nationalvoices.org.uk/our-work/five-year-forward-view/new-model-partnership-people-and-communities

Next steps for STPs in 2017 and beyond Ultimately, the NHS must turn STPs into delivery partnerships focused on implementing the proposals. Over the next few months, STPs will be working hard to ensure that their proposals are locally owned, clinically led and publicly supported. Most will be forums for shared decision making, supplementing the role of individual boards and organisations. A small number of STP partnerships may evolve into integrated or ‘accountable’ care systems. In these areas, providers and commissioners could come together, with a combined budget and fully shared resources, to serve a defined population. NHS England and NHS Improvement will help them by freeing up resources and helping to focus them on the things that matter most to patients and the public.   

How the VCSE has been involved to date Represented in governance of STPs programme boards, stakeholder reference groups Contributed to reviews of existing information as basis for plans: existing insight from patients and communities, e.g. previous consultations, VCS reports existing evidence of needs, inequalities Engaged via stakeholder events informing STP development Agreements for partnership working with VCSE VCSE Devolution Reference Group in Manchester Richmond Group partnership with Somerset STP Engagement via national channels Voluntary Sector Strategic Partnership Richmond Group People and Communities Board for 5 Year Forward View

Challenges and opportunities Systematic involvement in governance and implementation Working together across ‘footprint’: Build on existing relationships with system partners Share intelligence Clarity about who is representing VCSE and how to connect to them Role for VCS infrastructure organisations Link to national dialogue Articulating a clear VCSE offer/narrative Different roles of VCSE (e.g. provider, infrastructure, equalities, social enterprise.) Realising the Value resources Richmond Group ‘Untapped Potential’ publication Sharing good practice to drive better and more systematic engagement and co-production

Further information… More details can be found at: www.england.nhs.uk/stps Please email: england.fiveyearview@nhs.net Or join the conversation on Twitter using #FutureNHS

Questions? Any experience of good practice to share with colleagues? Views on now we can engage with VCSE on STPs: Nationally? At STP level? Other questions or issues to raise?