All 44 STPs published – but what do we know?
I am surprised that health commentators are surprised at the lack of detail in the STP proposals that have been published this week, what did we really expect?
Personally I am a relieved that the plans, sorry proposals, are still incomplete. The changes in structures, and crucially in the relationships in our interdependent health and care communities, are still in their infancy. Any more complete plans, offering all of the answers and "the finished product" would have been treated with even more suspicion on the ground.
Yes to minimise the risk of challenge on major reconfiguration plans (and STPs are certainly that with bells on – it is Christmas after all), you need well-developed plans. Too often, however, consultation and engagement is about a final plan and the only changes are at the absolute margins. STPs are too big, too new, too uncertain, and too important to take that approach – and get them accepted.
For that is the key challenge for STPs; they have to be understood and accepted by the 2 Ps, populations and politicians. There is a remarkable consensus amongst providers and commissioners, given their historic record of not agreeing on the big picture, of the need and case for change. Critically populations need to see why STPs are needed, why new care models are needed, why we cannot keep the current models. I am afraid that in these uncertain, populist political times, we cannot expect politicians to lead that debate.
So yes the STPs are interim proposals and yes the clock is ticking, but unless and until our patients and our communities see and accept the need for change, at the scale the STPs are proposing (and beyond), those proposals cannot be finalised and will not succeed. That is the real STP challenge for 2017.