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How will Sustainability and Transformation Plans (STPs) change the NHS in 2017?

Sue Thomas and Paul Midgley, of Wilmington Healthcare, assess the impact that STPs will have on the NHS and what this means for pharma.


During the past couple of years, the Five Year Forward View (5YFV) has been introducing fundamental changes
that aim to develop new, integrated and cost efficient models of care that suit local needs.
  These changes began with the introduction of vanguards - individual organisations and partnerships which were invited to trial new ways of running primary and secondary care services in their local areas.   The work of the vanguards will be expanded on a national scale this year by Sustainability and Transformation Plans (STPs), which will require all NHS healthcare providers - from primary to specialist and social care - to work together within 44 geographical areas or ‘footprints’.

How will STPs operate?

STPs are area­-specific, whole­-system, five-year plans which will identify the health needs of populations within the individual footprints, and define how they should be addressed quickly and effectively at a local level. They encompass all the health and social care commissioners and providers within the relevant locality, including local authorities, and will see health and social care plans combined for the first time.  

When they are formally introduced in April 2017, STPs will provide a framework for the way services will be delivered in their local area; while Clinical Commissioning Groups (CCGs) will have more detail on specific diseases.  So, for example, an STP will provide a framework for improving treatment for long-term conditions, while the CCG will define in more detail how individual long-term conditions, such as back pain and diabetes, will be managed.

Many STPs are using Primary and Acute Care Systems (PACs) and
Multispecialty Community Providers (MCPs) as templates and it is expected that there will be fewer CCGs. However, since there is no official 'template' for STPs, they give rise to the possibility of 44 different versions of the NHS, and the prospect of a truly devolved health and social care system.

One of the key objectives of STPs is to help the NHS deal with an expected £22 billion hole in its budget by 2020 by identifying and delivering savings, and increasing efficiency. 

In real terms, increased efficiency means fewer beds, fewer A&E departments and fewer services that the individual STP deems ‘unnecessary’. It could also lead to changes such as GPs and hospitals morphing into single organisations in some areas, and treatments, such as heart surgery and cancer care, being centralised across the country.  

STPs are also required to support the NHS’s ‘financial reset’, which will include reducing staffing costs and consolidating back office functions, reducing estate costs and disposing of surplus land.  

How can pharma work with STPs?

Amid the upheaval, there will be many opportunities for pharma to shape the way that services are delivered by working with a variety of different stakeholders, many of whom they may have had limited, or no contact, with in the past, such as local authorities, charities and patient groups. To achieve this, pharma needs to communicate the fact that it is not simply a drug manufacturer, but has a huge amount of expertise in specific therapy areas and can provide support in other critical areas such as new research and evaluation of existing data, and education.  

Understanding the bigger picture in terms of how STPs will affect areas such as NHS structure, leadership, commissioning, KPIs, efficiency, procurement and patient pathways is crucial for pharma. The industry also needs to get to grips with the priorities and primary objectives of the individual 44 STPs. One of the best ways to do this is to keep abreast of local STP plans and board meeting reports from stakeholders, such as CCG Chief Officers, which keep members up to date with local developments.

Armed with the latest knowledge, the industry should look to offer tailored solutions that fit with the aspirations of individual STPs and will help them to fulfil the needs of their local patient populations.  Joint projects with these stakeholders could include new research and existing
NHS Digital data analysis, and educational campaigns.

Securing appointments with senior STP figures isn’t essential, since they will not be doing all the groundwork. Indeed, it would be equally valuable to work with clinicians to help them develop a business case for an idea that they can present to payors. For example, if a group of clinicians wants to use a new drug but it keeps getting blocked by the prescribing committee, pharma could help doctors develop the business case by researching and supplying a variety of data, including the results of clinical trials, impact on the population and the amount of money that could be saved by transforming the patient pathway and outcomes.


The 5YFV has been quietly laying the foundations for a radical reform of NHS services and the full impact of these changes will be realised in April 2017 when STPs are introduced. However, amid the changes that are envisaged, there will be opportunities for pharma to help STPs navigate the best way forward. The key for pharma is to get to grips with the priorities and objectives of the STPs, keep abreast of their plans and seek to deliver solutions that are tailored to the needs of the 44 different localities. 

9th February 2017



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Wilmington Healthcare

01268 495600

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