Financial pressures undermining efforts to repair health and social care services, CIPFA warns


Sustainability and transformation plans (STPs), joint efforts between NHS bodies and local government to secure the future of health and care in England, are being undermined by financial pressures, according to CIPFA, the Chartered Institute of Public Finance and Accountancy.

In a submission made to the Health Select Committee, CIPFA highlights how a focus on plugging short-term gaps in resources and capacity has meant there has been insufficient concentration on ensuring that STPs achieve their ambitious goals.

CIPFA warns that grappling with short-term financial pressures has led to:

  • a lack of the concrete transformational changes needed to achieve the ambitions set out for STPs
  • little sign that investments are being made on preventative measures that will help make services more sustainable in the long term
  • not enough upfront investment to ensure systems and infrastructure are in place to support STPs, as well inadequate revenue investment to stabilise budgets
  • insufficient response to critical issues, such as workforce shortages, and lack of action to achieving long-term financial sustainability
  • ambitious plans that have not been assessed to determine whether or not their scope is credible.

In order for the transformation plans to succeed, CIPFA urges the government to make sure that the necessary resources are available and that the scope of the plans are more realistic.   

Commenting on the submission, Chief Executive of CIPFA and Chair of East London Health and Care Partnership, Rob Whiteman, said:

“STPs are our best shot at making meaningful and lasting improvements to health and social care services. And across the country, many STPs are making a promising start. 

“To ensure STPs can reach their full potential, it is important that they are supported by a greater level of resources and that their plans are realistic. Otherwise, the transformation agenda will be jeopardised and services will continue to be at risk.”


For further information please contact Saskia Black on T: 020 7543 5830 or E:

Notes to editors

Please contact the press office for a copy of CIPFA’s response to the Select Committee on Health’s inquiry into STPs.

CIPFA, in the submission, also made the following recommendations to the government.

  • All NHS inspection should be carried out at the level of the STP footprint, not at the organisational level.
  • The Treasury should release the shackles it places on NHS capital investment, and indeed on the preventative revenue investment that represents the only long-term hope of reaching a financially sustainable position.
  • There needs to be a more realistic split between short-term necessities (to stay within control totals) and longer-term investment (which may well not be in place as required, in this instance it should be flagged as an issue for negotiation). That may in turn require the government to make a more realistic assessment of the balance between service expectations and resources availability in the NHS.

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