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We need patients and the public to shape local health plans, say NHS leaders

Patients and the public across England are set to be asked to help the local NHS make decisions about how best to develop services.

The NHS in England is today (Thursday) publishing national advice for local health and social care leaders preparing what are known as local Sustainability and Transformation Plans (STPs).  The advice sets out how to put the communities they serve at the heart of their work.

Under a new, collaborative approach announced in January, local leaders have come together in 44 STP areas, covering every part of England, to work through how best to spend funding growth and transform care in the face of rising demand and more complex patient needs.

Although funding is increasing, the NHS needs to ensure its services are as efficient as possible, eliminating waste and duplication, and making sure that patients receive the services they need in the right place and at the right time.

This means fewer hospital stays when care could be given at or closer to home, as patients say they want. It also means tackling the causes of ill health early on, not just treating the symptoms.

This Autumn, every STP area will be developing proposals for how they will use the increased funding over the next few years to improve health and wellbeing, transform care quality and ensure financial sustainability.

Local areas are responsible for involving patients and communities in their draft proposals. Each is working to its own, locally appropriate timetable but many have already carried out extensive engagement with the public. These include:

  • Mid and South Essex local leaders have incorporated feedback from patients, councillors and others about its overview plan since March, resulting in a stronger emphasis on prevention and the development of mental health care. It has also spoken to hundreds of patients and staff about potential options for re-designing local hospital care.
  • In South West London, the NHS is working in partnership with Healthwatch to talk to people whose voices are less often heard in engagement. It expects to hold seven to ten events in each borough, and wrote directly to more than 1,000 local community groups in May to share it emerging thinking and asking people for their views. All feedback is being considered as part of the STP planning process.
  • Plans in South East London build on extensive conversations between the NHS and the communities they serve about local challenges and priorities. This has included large-scale public events in each borough, and involving patients and the public in clinical groups to discuss area-wide strategy.

Proposals for every part of the country are planned for late October/November, with most areas likely to start preparing for more formal local engagement and consultation by the end of the year.

The new guide includes advice on:

  • using lay representatives and establishing patient reference or advisory groups;
  • considering and carrying out formal consultation with enough time for the public to make their views heard;


  • testing options with local councils and other important stakeholders, where possible by building on the work of existing bodies such as health and wellbeing boards.

Many local health systems are already publishing summaries of their proposals for patients and the public, with others expected to do so later this year. Relevant organisations such as hospital trusts have also been advised to devote a public board meeting in full to discussing proposals.

The NHS stresses that, in order for conversations with the public to be meaningful, proposals must be practically viable. Plans are understandably at different stages and NHS England and NHS Improvement will help ensure their development is rigorous.

Jo Lenaghan, Project Director for the NHS Five Year Forward View, said: “There is consensus that the NHS needs to change to better meet the needs of today’s patients and we know broadly how it needs to change with more care outside of hospital.

“The issue local health and social care leaders are now grappling with is how to make this real in their part of the country.

“There is a huge prize to be had that includes better joined-up care, services closer to home and improved outcomes for older people. But to achieve those benefits communities will have to confront choices about where to put modestly growing resources.

“Local health and social care leaders know they can only invest funding growth wisely if they understand people’s priorities. So, public engagement is not just a public duty but the prerequisite for a high-quality, viable plan for the future.

“To enable local conversations to work well,  local health and social care leaders are preparing workable proposals for their communities, built on a bedrock of partnership not fragmentation, the only way to succeed in today’s NHS.

“For too long, health and care leaders were asked to draw up plans for single organisations instead of for the whole communities they serve.

“Local proposals need to be viable, real-world propositions. Every part of the country has a unique history so states of readiness vary and geographies will rightly move at different speeds.

“No one should be under illusions that the choices here are easy.  The health and care system we have today was designed for a different age. We hope all those involved will help us get this right – it is critical to the health of our NHS.”

Dr Anita Donley OBE, leader of Mid and South Essex footprint, said: “We made a commitment from the start that clinicians and local people would drive the development of our proposals. The feedback we’ve had so far is rich in important details that will support patients and public in being able to access a very different health and care system in the future.”

Channel website: https://www.england.nhs.uk/

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