Sustainability of the NHS is reliant on upfront investment, robust governance and awareness of risk


The success of the NHS’s Sustainability and Transformation Plans is reliant on realistic plans that set out appropriate actions, while fostering a culture of genuine sharing and working together, according to the Chartered Institute of Public Finance and Accountancy (CIPFA).

In its assessment of the 44 draft STP plans, CIPFA says that while in principle STPs represent a positive, place-based step forward, the timescales and speed of savings required have led to a number of ‘business as usual’ propositions, rather than the development of the concrete, transformational changes needed to deliver financial sustainability in the long term.

If STPs are going to have a meaningful impact on what CIPFA estimates to be a £10bn funding gap by 2020/21, there must be adequate upfront investment; robust governance arrangements; and thorough contingency planning, with realistic assessments of alternative scenarios.

Rob Whiteman, CIPFA Chief Executive, said: “Service integration is a no-brainer for patients, families and stretched NHS teams and as a means of addressing the need for financial stability in the health sector, STPs offer a promising start towards taking forward the changes needed in the health and social care system.

“In reviewing the 44 plans, it is clear that much still needs to be done, particularly in developing full scenario planning and understanding risk. Transparency and realism is crucial, even if it does expose the difficulties involved in achieving the plans. Otherwise there is a danger that the desire to present a positive position will lead to unrealistic judgements being made.

“To this end, CIPFA is keen to support finance leaders, from both the NHS and local government, involved the preparation of STPs so that they feel able to represent a realistic assessment of the financial position.”



Notes to editors

To read CIPFA’s Reality Check: Next steps in developing sustainability and transformation plans, click here.