Hempsons is pleased to bring you the latest in its series of news updates on new care models, STPs and integration.
Clearly there is much uncertainty about the future for this government. At this stage, however, we can identify two key points of continuity for the NHS: the reappointment of Jeremy Hunt as Secretary of State and the Conservative manifesto commitment to “back the implementation of the Five Year Forward View plan at a local level, through the Sustainability and Transformation Plans, providing they are clinically led and locally supported”.
The Conservative manifesto also committed the government to consulting and making necessary legislative changes “if the current legislative landscape is either slowing implementation or preventing clear national or local accountability”. There will be doubt about whether the government will be able to make any such changes. But it is worth considering what they might be. We have produced a short update about this, available here.
2. ‘Governing for transformation: STPs and governance’ guide – new foreword by Professor Paul Stanton
The effective creation and delivery of local STPs is now a key task for any healthcare leader. There is a clear consensus that creating effective governance for the STP process is vital, but this is not something that has collectively been done well enough up to now, and it is recognised as a potentially complex issue.
In partnership with NHS Providers, we have launched an updated version of our report, Governing for transformation: STPs and governance.
The report sets the context for STPs, identifies the challenges for organisations, examines the role of the board, and addresses the constraints of current legislation.
Next Steps of the Five Year Forward View (March 2017) sets out plans for the transition of the NHS to population-based integrated health systems. This will be achieved by the evolution of STPs into Accountable Care Systems (ACSs) and in some areas eventually into Accountable Care Organisations (ACOs).
NHS England rightly acknowledges that one size does not fit all and STPs are continuing to develop at different speeds with different arrangements for STP leadership and accountable care. This briefing identifies seven key steps STPs and their partner organisations should consider to support the evolution to accountable care.
Sir Robert Naylor has recommended that STPs should develop “stretching” local estates plans – supported by robust business cases – to release surplus land and buildings from the NHS Estate. The powerful new NHS Property Board will be responsible for ensuring that STPs plans to release land are strategically benchmarked and suitably challenging for each STP.
Naylor describes the potential to release up to £5.7 billion (and potentially more) of sale proceeds from the disposal of surplus assets by STPs as a “major opportunity” to release a key source of untapped funding to meet the anticipated £10 billion cost of transforming NHS services pursuant to STP plans. Naylor also identifies a total potential opportunity to provide up to 40,000 homes – many of which should be prioritised for NHS staff – on the land to be released by STPs.
STPs will be incentivised to dispose of their surplus assets by being allowed to retain the proceeds locally and by a proposed “2 for 1” funding offer from the Treasury, whereby public funds will be used to effectively double STPs’ capital receipts following the sale of land.
One major challenge for STPs to overcome, however, will be to manage the interests of the different NHS providers within the 44 STP areas.
Michael Dulhanty, Real Estate Partner at Hempsons comments “The vast majority – approximately 85% – of the NHS Estate is owned by NHS trusts and foundation trusts. It will be interesting to see how these estate-rich providers within each STP will be encouraged to release their own surplus estate holdings for the greater good of their STP, assuming of course that the recommendations of the Naylor Review are implemented following the outcome of next month’s general election.”
For more information regarding the Naylor Review and its implications please contact Michael Dulhanty.
Hempsons’ Integration Resource Centre contains a series of articles and in-depth reports on new care models, integration, STPs and governance.
Have a browse through the available topics and contact us if you have any questions.