NHS transformation plans promising but unrealistic, CIPFA warns


Despite sustainability and transformation plans (STPs) emerging as a good means of addressing the need for financial stability, some strategies drawn up do not include enough substance to prove they are tackling the problems realistically, according to a new report released today (18 November) by CIPFA.

In the report, CIPFA has analysed nine published STPs out of the 44 that are being developed in England to improve services while reducing costs. It found that although the plans set out proposals to close the widening financial gap, which the NHS estimates to be £30bn by 2020, some fail to set out a credible case for the deliverability of their savings plans. 

CIPFA found that few plans quantify the risk of additional pressures developing and of savings not being delivered. Considering many are proposing radical action, CIPFA believes that this kind of contingency planning must be included to ensure the STPs are achievable. 

The report also reveals that in some cases the savings targets appear over-optimistic, due to a failure to put them into context by showing savings as a percentage of relevant spend. CIPFA claims that this would give a better idea of how challenging saving plans would be to achieve. 

Overall, CIPFA does support STPs as the solution to stabilising the financial position of the sector.  

CEO of CIPFA Rob Whiteman said: “In order to improve care for local communities, STPs will have to make tough choices to deliver meaningful change.

“However, it is of vital importance that STPs fully assess whether the actions proposed can actually meet savings targets and boost the quality of services by doing robust financial planning. STPs are our best shot at making our health and social care sustainable for future generations. Therefore, local leaders and NHS providers must do all they can to ensure that the proposals are deliverable.”

The report’s findings also include:

  • There is more scope for STPs to make better use of integrated working.
  • The majority of STPs analysed include an assessment of social care pressures, but without setting out a joint approach between councils and health partners to tackle the problems raised.
For media enquiries contact the CIPFA press office on T: 020 7543 5830 or E: Saskia.black@cipfa.org 

Notes to editors

CIPFA’s STP report, Sorting the Plans, is available available online. 


The Chartered Institute of Public Finance and Accountancy (CIPFA) is one of the leading professional accountancy bodies in the UK and the only one which specialises in the public services. It is responsible for the education and training of professional accountants and for their regulation through the setting and monitoring of professional standards.
Uniquely among the professional accountancy bodies in the UK, CIPFA has responsibility for setting accounting standards for a significant part of the economy, namely local government. CIPFA’s members work (often at the most senior level) in the public service bodies, in the national audit agencies and major accountancy firms. They are respected throughout for their high technical and ethical standards and professional integrity. CIPFA also provides a range of high quality advisory, information and training and consultancy services to public service organisations. As such, CIPFA is the leading independent commentator on managing and accounting for public money.