Stevens: STPs will get ‘decision rights’ to reorganise trusts and CCGs

HSJ, 9 FEBRUARY, 2017

BY JAMES ILLMAN

  • STPs to be given right to “recommend” member trusts and commissioners reorganise
  • STPs should act if “veto power or inertia is getting in the way of the bigger strategic change agenda”, Simon Stevens says
  • NHS England chief also says new forward view update plan is not “not a funding bid”

Sustainability and transformation plan leaders will be given the right to “recommend” member trusts and commissioners reorganise, where the “veto power or inertia” of individual organisations is holding up change, Simon Stevens has said.

The NHS England chief executive told the body’s board meeting today the STPs were “here to stay” and the Five Year Forward View delivery plan, due next month, would “beef up the implementation capability which exists at STP level”.

Mr Stevens said the delivery plan will propose STPs are given “decision rights”, “not only over many of our activities, but also the ability to recommend changes to the configuration or governance of constituent statutory organisations in those geographies where the STP believe that veto power or inertia is getting in the way of the bigger strategic change agenda, which is required in that part of the country”.

A formal appointment process for STP leads is also being drawn up as part of the delivery plan, which will set out NHS England’s plans for the next two years “and for some of the deliverables, a bit beyond that”, he said.

He also sought to pour cold water on suggestions that the delivery plan was an attempt to reopen spending negotiations between the NHS and government.

He said: “[The delivery plan] is not a bidding document for NHS funding. What it is, is taking as a starting point something which the government has allocated to the NHS… and then… saying what realistically can the NHS deliver over that period.”

Mr Stevens, speaking just an hour after official data revealed accident and emergency performance in December had sunk to its lowest level since the data started being collected more than a decade ago, said addressing urgent and emergency care would be a focal point for the delivery plan.

He said: “Part of the answer [is a more] streamlined urgent treatment centre offer, extended access to convenient primary care, and substantial changes to the way 111 is networked.

“But really the principal driver… is the availability of inpatient beds in the hospital which people are able to admit to. The biggest change over the course of the last year, the last three years, has been the effective reduction of bed availability resulting from the fact that social care related delayed discharges has gone up by 90 per cent over the course of the last two years.”

The meeting also heard from chief financial officer Paul Baumann, who set out his finance report which revealed the overspend by clinical commissioning groups in England had almost doubled in the last three months, with a third of CCGs now predicting in-year deficits.

After the first nine months of 2016-17, CCGs have forecast a year-end overspend of £370m, compared to £190m forecast three months earlier.