Council capabilities must be ‘put to use’ in STP joint work, says CIPFA

The sustainability and transformation plans (STPs) lack robust plans to deliver savings and should make more use of integrated working, the Chartered Institute of Public Finance and Accountancy (CIPFA) has said.

CIPFA reviewed nine of the STPs which have now been published, which between them contain plans for savings of £5.3bn.

It found that while all the STPs contained proposals to close the financial gap in the NHS, many did not provide a credible explanation for how they would deliver the savings.

Rob Whiteman, the institute’s CEO, said: “In order to improve care for local communities, STPs will have to make tough choices to deliver meaningful change.

“However, it is of vital importance that STPs fully assess whether the actions proposed can actually meet savings targets and boost the quality of services by doing robust financial planning.

“STPs are our best shot at making our health and social care sustainable for future generations. Therefore, local leaders and NHS providers must do all they can to ensure that the proposals are deliverable.”

The report criticised some STPs for setting out proposals for achieving long-term stability without explaining how they would reduce the deficit between now and 2020, as well as lacking plans to deal with risk factors. Only one STP included a quantified contingency plan.

CIPFA’s review also contained the results of a roundtable on STPs, which stressed that social care, public health, housing, leisure and policing services should be considered in plans to improve healthcare.

The institute advised local STP partnerships to set out the pressures and savings in both health and social care in order to understand how one affects the other, and to review what integrated work could contribute to delivery.

It recommended the plans should be delivered by joint work between different local public services, including co-commissioning, population health planning and preventative support for older people.

In particular, CIPFA recommended that local government’s “generally good” record in service design, resource allocation and public engagement should “be put to use” in delivering STPs – potentially through using their more flexible sources of capital, such as prudential borrowing.

Currently, STP implementation is being captained by health services in many places, rather than by local authorities.

A PSE investigation earlier this year found that less than a third of councils were involved in appointing their STP’s leadership, and a separate survey showed that over three-quarters of county adult social care directors do not believe their local STP will deliver sustainable care.

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