The government has called for sustainability and transformation programmes to demonstrate concrete progress, indicating that the scheme must deliver “the productivity and efficiency gains necessary to maintain financial balance”.
44 areas are currently involved in the STP process, and while there have been some positives there is also scepticism regarding the efficacy of the initiative.
In the latest annual mandate to NHS England, the Department of Health outlined its desire for the sustainability and transformation program to develop significantly.
But the fact that this mandate was delivered more than three months later than usual has raised eyebrows.
The authorities have indicated that the ongoing, and sometimes heated, debates between government and NHS England over delivery and accountability, has played a major role in this tardiness.
Sustainability and transformation has been a particular bone of contention, but financial performance and emergency care have also caused considerable dialogue.
Sectors of government have been disappointed that many STPs didn’t produce robust cost-saving actions in their first year.
The document states that in future “a number of metrics will be used to measure progress across STP footprints in delivering the Five Year Forward View, linking performance of the NHS at a local level more explicitly to national accountability”.
However, the government has declined to provide any more details regarding the process at this time.
It is also notable that the document calls for the four-hour emergency waiting target to be met satisfactorily by the end of the 2018 calendar year.
This does represent the data being pushed back slightly from the previous targets.
But other headline targets must be met immediately.
This news promopted NHS Providers to assert that the “gap between demands on the health service and the resources available in the coming year remains unbridgeable”.
Meanwhile, in a foreword to the mandate, health secretary Jeremy Hunt outlines the way that the STP programme will develop in the forthcoming financial year.
“2017-18 should be the year in which we see concrete progress on local sustainability and transformation plans…As partof this effort, the government has already made £325m of capital funding available for the best STPs over the next three years. In the autumn a further round of local proposals will be considered.”
And also suggests that productivity and efficiency should be a particular focus of the NHS in this 12-month period.
“2017-18 should also be the year when the NHS delivers the productivity and efficiency gains necessary to maintain financial balance by tackling unwarranted variation, reducing waste, bearing down on the exorbitant costs of agency staff and better managing demand.”
While the health secretary asserts that the quality and consistency of service delivered by Accident and Emergency must improve.
Healthwatch England, which must be legally consulted on this mandate, welcomes the targets put in place.
Chair Jane Mordue suggested that the new approach could “help improve thousands of people’s experience of care and reduce the financial and human cost caused when discharge goes wrong”.