The NHS is a complex system. For years we’ve seen the launch, implementation and eventual demise of a range of reforms and initiatives, so the concerns we’re hearing from colleagues across health and care systems about STPs might be considered somewhat justifiable. STPs are an ambitious endeavour launched to integrate health services across the UK, but how exactly will services be delivered? And most importantly, do they have a sustainable future in the health system?
The NHS is a complex system. For years we’ve seen the launch, implementation and eventual demise of a range of reforms and initiatives, so the concerns we’re hearing from colleagues across health and care systems about STPs might be considered somewhat justifiable. STPs are an ambitious endeavour launched to integrate health services across the UK, but how exactly will services be delivered? And most importantly, do they have a sustainable future in the health system?
The NHS looks after more than 1 million patients every 36 hours, so effective partnership working rooted in the reality of delivery is the only way we can provide high quality care across the health and care landscape. STPs have been borne out of services themselves rather than being passed down from ‘above’, with frontline staff heavily involved. But leadership will still play a critical part in their development. Leaders will need to ask themselves:
1. ‘Am I able to think about what’s best for our local citizens and systems, and not just my organisation?’
2. ‘Do I have the capability, skills and knowledge to lead my STP footprint effectively?’
Bringing to life the ambitions of STPs will be challenging but rewarding and will be in large part reliant on developing and supporting compassionate, inclusive leaders who can drive innovative ideas during times of change. We know there’s a very clear link between leading well and the positive impact on staff, which will in turn lead to high quality care for patients being delivered at the frontline.
To have effective partnerships across the footprints means we need to have good leadership at every level within organisations and of the STP itself. Following the publication of the Developing People and Improving Care framework it became clear that our network of Local Leadership Academies (LLAs) would have a critical role in supporting systems, including bespoke support to STP leads.
Discussions between LLAs and STP leads are currently ongoing to establish what leadership support they require, and a number of tailored offers have already been developed. This has included a range of coaching and mentoring offers as well as masterclasses and longer-term programmes. Each footprint is developing at its own pace, taking into account the needs of its local population, so the leadership development support required will be different in each area.
For example, I know the south west footprint has developed its own organisational development programme while the east of England STP has been focusing on health coaching. We will continue to work as part of an overall network of Academies to understand the needs of each area and support them to develop and deliver tailored leadership offers.
As well as supporting local partners, the Academy is also working at a national level to support STP leaders. The Academy provides a range of offers for STP leaders, including the Elizabeth Garrett Anderson (EGA) programme. The programme is aimed at equipping mid to senior level leaders across the system with the right attitudes, behaviours and skills to challenge the status quo and lead a culture of compassion.
Ultimately, it’s about empowering people with the tools to drive real and lasting change to improve the patient experience. This is particularly critical if we want leaders who can ensure that organisations operate more effectively across STP footprints.
We should be able to get to a point where we can say service providers are delivering the same high quality care in every part of the country. I firmly believe that by working together with less duplication of effort and using resources to their full effect, people’s health will improve. That’s the ultimate goal of STPs. But there are a number of challenges:
- Trust: How do you build this in relationships which might not have existed before, or were simply transactional? We know organisations will continue to have their own statutory obligations and so there can be a tension between what they want to do on behalf of the system and what this actually means for their own organisation
- Funding: How do we deliver the plans when resources are so scarce? It was only last year when NHS providers recorded one of the largest deficit in the history of the health service. How do we create the climate to carry out the change while ensuring high quality care is being delivered? The answer is to invest in and empower staff
- Engagement: Speaking to the public, patients and staff is key. If we don’t hear from people who use our services or individuals who deliver services, how are we meant to develop something suited to their needs? I think it’s fair to say that engagement hasn’t been fully developed, in particular clinical engagement. STP leads must ensure they capture people’s thoughts and opinions and feed this back into the delivery plans
Many academics, politicians, journalists and colleagues from across the NHS have commented on STPs’ viability and success, but people need to recognise that they are very much in their early stages and not fully formed yet. I’m also a firm believer that, while STPs’ work is important, there’s a need for individual teams and organisations which are working tirelessly behind the scenes to ensure good quality services are being delivered. STPs are providing a space for conversations to happen, which means leaders can come together from a range of landscapes to have a discussion.
Caroline Chipperfield is the associate director of partnerships at the NHS Leadership Academy.
