Please login to the form below

How will Sustainability and Transformation Plans (STPs) change the NHS commissioning landscape?

Sue Thomas and Paul Midgley, of Wilmington Healthcare, take a look at new commissioning structures and what they mean for pharma
The official roll-out of Sustainability and Transformation Plans (STPs) in April will herald the dawn of a new era for NHS commissioning as the old divisions between primary and secondary care are finally swept away.  

Key changes will include a reduction in the number of commissioners. For example, the Birmingham and Solihull STP plans to merge its three CCGs; while Lancashire and South Cumbria propose a single health and well-being board.  

There will be new roles for the remaining CCGs, which will be empowered to commission services across the entire care pathway – from diagnosis through to end of life care – following new co-commissioning arrangements with NHS England.

Each of the 44 STPs will adopt a different approach to commissioning services, based on local needs and conditions. NHS England's strategic framework for specialised services has called for an area-by-area approach, and a move away from the 'binary' system where services were either nationally or locally commissioned.

Wilmington Healthcare has been following the progress of all the 44 STPs in great detail, via its tracker system for the past six months. Pharma needs to drill down into the individual footprints in a similar level of detail in order to get to grips with STPs’ priorities and objectives, both top line and therapeutic, and obtain budgetary information and population statistics. It also needs to find out information, such as the burden of diseases in individual areas, and the key specialists.

To clarify its approach, pharma needs to think about the service now:

Which provider incurs the cost of delivering the service?

2.    What are all the inputs currently required to deliver the service, including staff, premises, materials, medicines, training and travel?
3.    Which commissioner currently pays for the service and what type of contract and tariff is used?
4.    What is currently charged to the commissioner for buying the service?  

Pharma also needs to think about the service of the future:
Which provider will incur the future costs of delivering the service? As well as looking at how costs are going to change, think about who will incur these costs. 

What model is the provider working to – e.g. are they an Accountable Care Organisation (ACO) working on an outcomes-based contract built up from a capitated budget?

Which commissioners will pay for the new service and what will be charged to them? What will be the difference for commissioners after the service change?

Are there other consequences of a service change in terms of costs incurred to the NHS?  For example, might your product reduce hospital admissions – is it given less frequently than competitors, or orally instead of by infusion?  

Can the provider realise these savings through their model e.g. an ACO will look at system wide costs and may see an investment in drug prescribing as an opportunity to change the pathway of care to a more cost-effective community based service.

Pharma needs to understand how new patient pathways will work in the individual STPs, from diagnosis to death, and define how its products will fit into those pathways and really make a difference. To achieve this, it will need versatile customer-facing teams who are comfortable working with a variety of stakeholders, many of whom they may have had limited or no contact with in the past – such as local authorities, charities and patient groups – as well as clinicians across a wide spectrum of NHS services and particularly in CCGs and new much larger provider ACOs.  


Sue Thomas is CEO of the Commissioning Excellence Directorate and Paul Midgley is director of NHS insight, both at Wilmington Healthcare. For information on Wilmington Healthcare, log on to

23rd March 2017


Company Details

Wilmington Healthcare

01268 495600

Contact Website

Beechwood House
2-3 Commercial Way
Christy Close
SS15 6EF
United Kingdom

Latest content on this profile

Wilmington Healthcare survey finds many doctors fear the NHS will fall victim to another ransomware attack
Following the ransomware attack that wreaked havoc on NHS IT systems last year and resulted in major disruption to patient care, the majority of doctors surveyed by healthcare intelligence provider Wilmington Healthcare say they believe another attack is likely.
Wilmington Healthcare
Innovative NHS suppliers scoop HSJ Partnership Awards
Winners include pharma, medtech, healthcare consultants and IT specialists. Innovative pharma and medtech companies have been honoured in an awards scheme run by Health Service Journal (HSJ), the news and information service for all healthcare leaders working in, for, or with the NHS.
Wilmington Healthcare
Managing local population needs is key for the NHS
Steve How, Paul Midgley and Sue Thomas, of Wilmington Healthcare, explore population-based planning in the NHS and what this means for pharma
Wilmington Healthcare
Large-scale NHS commissioning models require new partnership approach from pharma
Steve How, Paul Midgley and Sue Thomas, of Wilmington Healthcare, explore how pharma should respond to the NHS’s move towards more collaborative, joined up working
Wilmington Healthcare
Leading NHS suppliers highlighted in shortlist for new HSJ awards

Wilmington Healthcare
Shining a light on the true cost of patient care
Sue Thomas and Paul Midgley, of Wilmington Healthcare, explore how the proposed national patient data sharing scheme would change the NHS
Wilmington Healthcare