What Is The Sustainability And Transformation Plan?

by | Feb 15, 2024 | Sustainability, Sustainable Development

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The Sustainability and Transformation Plan (STP) emerged in 2016 as a pivotal initiative within NHS England, aiming to revolutionize healthcare delivery. This non-statutory plan sought to integrate health and social care services, implement innovative practices, and ensure the long-term financial viability of the NHS. Despite facing challenges, its principles continue to shape the evolution of healthcare transformation.

What was the STP?

The Sustainability and Transformation Plan (STP) introduced in 2016 was a significant initiative to transform healthcare delivery within NHS England. It was a non-statutory plan designed to address the challenges faced by the healthcare system and to improve patient care, resource utilization, efficiency, and financial sustainability. The STP had three main objectives:

1. Integration: The STP sought to integrate health and social care services to provide more coordinated and seamless patient care. By breaking down silos between different parts of the healthcare system, it aimed to improve patient experiences and outcomes while maximizing the use of resources.

2. Transformation: Through the adoption of innovative practices and technologies, the STP aims to transform the delivery of healthcare services. It included initiatives such as digital health solutions, new care models, and redesigned pathways to enhance efficiency, quality, and care accessibility.

3. Sustainability: Ensuring the long-term financial viability of the NHS was a key priority of the STP. By identifying efficiencies, reducing waste, and optimizing resource allocation, it aimed to address financial challenges while maintaining the quality and availability of healthcare services.

What Happened to the STP?

Despite its ambitious goals, the STP faced several challenges that limited its effectiveness:

  • Funding and accountability: The lack of precise funding mechanisms and accountability structures hindered the implementation of the STP. It made it difficult for stakeholders to secure the necessary resources and support for transformational changes.
  • Centralization concerns: There were concerns among stakeholders about the potential centralization of services under the STP, which could lead to the loss of local autonomy and control over healthcare provision.
  • Collaboration difficulties: Achieving meaningful collaboration between different organizations involved in the STP proved challenging. Differences in priorities, incentives, and organizational cultures often impeded effective partnership working.

While the STP’s prominence waned, its principles continued influencing healthcare strategies, mainly through the evolution towards Integrated Care Systems, reflecting a dynamic pursuit of sustainable and integrated healthcare delivery.

Why is STP not the Main Framework Anymore?

The shift from the Sustainability and Transformation Plan (STP) as the primary framework for healthcare transformation in NHS England can be attributed to the emergence and prioritization of Integrated Care Systems (ICSs). There are two main reasons for this shift:

1. Statutory Footing

ICSs, established through statutory mandates in the NHS Long Term Plan, possess a more substantial legal backing than the non-statutory STP. This legal foundation empowers ICSs with more explicit authority and accountability structures, facilitating collaborative decision-making and effective healthcare delivery.

2. Population Health Management

ICSs prioritize managing the health of entire populations, moving beyond individual services or conditions. Through a population health management approach, ICSs address the broader determinants of health, emphasizing preventive measures and early interventions to enhance overall well-being and achieve more equitable healthcare outcomes.

The shift towards Integrated Care Systems (ICSs) as the main framework for healthcare transformation in NHS England is driven by their stronger statutory footing and focus on population health management. These characteristics enable ICSs to overcome some of the STP’s limitations and drive more comprehensive and sustainable improvements in healthcare delivery.

What Does This Mean Today?

Today, the Sustainability and Transformation Plan (STP) legacy continues to influence healthcare delivery in NHS England by developing and implementing Integrated Care Systems (ICSs). Several critical implications of this transition are evident:

  • Relevant Goals: Many STP objectives, such as integrated care and innovation, continue to guide healthcare transformation efforts within the ICS framework.
  • Shifted Implementation: The focus now centres on collaboration within a statutory framework provided by ICSs, ensuring accountability and facilitating coordinated action among stakeholders.
  • Local Adaptation: ICSs allow tailored strategies to address local needs, empowering communities to improve healthcare.
  • Monitoring and Evaluation: Ongoing assessment ensures progress tracking, identifies areas for enhancement, and maintains transparency in decision-making.

The transition to ICSs maintains STP goals while refining implementation for more effective and sustainable healthcare transformation.

Also Read: What Is The Concept Of Right To A Healthy Environment?

What’s Next?

The future of NHS England’s healthcare transformation will be shaped by some important initiatives going forward:

1. Advancement of the Integrated Care System

Each Integrated Care System (ICS) region will continue implementing its plan, drawing upon best practices and lessons learned from other areas. As ICSs mature, they will be increasingly central in driving integration, improving care coordination, and enhancing population health outcomes.

2. National Support for ICS Development

NHS England will provide ongoing guidance, support, and resources to facilitate the development and implementation of ICSs. It includes sharing successful strategies, facilitating collaboration between regions, and addressing common challenges to ensure consistency and coherence in healthcare delivery nationwide.

3. Performance Assessment of Healthcare Improvement

Robust monitoring and evaluation mechanisms will track progress toward achieving Sustainability and Transformation Plan (STP) goals and ICS objectives. By assessing performance, identifying areas for improvement, and sharing insights, stakeholders can continuously refine strategies, optimize resource allocation, and drive meaningful improvements in healthcare quality and outcomes.

Overall, the evolution of healthcare transformation in NHS England will be characterized by continued collaboration, innovation, and learning. Through the ongoing development and refinement of Integrated Care Systems, supported by national guidance and rigorous evaluation, the healthcare system will be better equipped to address current and future challenges, deliver high-quality care to all patients, and improve the overall health and well-being of the population.

How does the STP Legacy live on in ICSs?

The legacy of the Sustainability and Transformation Plan (STP) continues to shape the development of Integrated Care Systems (ICSs) in NHS England:

  • Integrated Care: ICSs prioritize integrating health and social care services to provide seamless and coordinated care, effectively addressing patients’ holistic needs.
  • Transformation: ICSs continue the STP’s drive for innovation in healthcare delivery, leveraging digital technologies and multidisciplinary teamwork to enhance quality, efficiency, and care accessibility.
  • Sustainability: ICSs maintain the STP’s focus on ensuring the NHS’s long-term financial viability, emphasizing value-based care, prevention, and efficient resource allocation.
  • Local Engagement: Despite broader geographic reach, ICSs prioritize local engagement, involving communities and stakeholders in designing responsive healthcare services.

The STPs live on in the guiding principles underpinning Integrated Care Systems’ development. By embracing integrated care, driving transformation, prioritizing sustainability, and fostering local engagement, ICSs are building upon the foundations laid by the STP to drive positive change and improve healthcare delivery for all patients in NHS England.

Current Landscape and Future Outlook

In the current landscape of healthcare transformation in NHS England, several vital elements shape the trajectory and future direction of Integrated Care Systems (ICSs):

Sustainability and Transformation Plan

The current landscape of healthcare transformation in NHS England is characterized by ongoing implementation, national oversight, evaluation, and adaptation.


The Sustainability and Transformation Plan represented a bold endeavour to address the complex challenges facing NHS England. While its prominence may have diminished, its legacy lives on in the ongoing development of Integrated Care Systems. As healthcare evolves, integration, innovation, and sustainability principles remain paramount in driving positive change and improving patient care.

Also Read: Embracing Sustainability In The Restaurants Industry



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