“Secret plans to change our NHS”: This is the allegation levelled at sustainability and transformation plans (STPs) – the government’s latest NHS reform initiative – by campaigning group 38 Degrees. Some politicians seem to agree, with former shadow health secretary Diane Abbott calling them “a dagger pointed at the heart of the NHS”.
Simon Stevens, the chief executive of NHS England, sees it differently: “Now is quite obviously the time to confront … the big local choices needed to improve health and care across England.” For him, STPs are a way of delivering the reforms he set out in the NHS Five Year Forward View (pdf) and the £22bn of efficiency savings he promised to the government, while maintaining or improving the quality of care.
As details of the STPs have been made public and the extent of the winter crisis in the NHS has become apparent, the debate about their role in the health service has become dangerously polarised. The question is whether these controversial plans will prove to be kill or cure. Based on a detailed analysis of all 44 plans, we at IPPR think the reality is probably more nuanced and complex than either side let on.