Since January 2016, we have witnessed the beginning of a revolutionary change for the NHS with the introduction of Sustainability and Transformation Plans (STPs). These plans are designed to facilitate partnership working within health systems to tackle some of England’s most complex health and social care priorities.
Wendy Lane, Consultancy Services Director at NHS Arden & GEM Commissioning Support Unit takes a look at some of the challenges for CSUs in supporting the STP process.
In a few short months, health and social care organisations have had to adapt to planning in new regional STP footprints. Organisations have to work together effectively to identify their local health priorities and find innovative and sustainable solutions to improve patient care, whilst delivering affordable services. In some cases, planning footprints bring new combinations of organisations together, with challenges to build effective collaboration at pace; in others the footprints may be more familiar but the problems to be addressed can be highly complex. This is leading to a shift in requirements from Commissioning Support Units (CSUs) both in terms of the combinations of skill set required and speed. In helping their customers rise to the challenges posed by STPs, CSUs are adapting fast.
Understanding the challenges
STPs bring a unique set of challenges for each of the organisations involved – including CSUs. STPs have created new regional collaborations for us to support.
The overarching challenges emerging are developing robust partnerships, understanding and responding to local needs and establishing sufficient data to enable confident implementation of innovation. Within this is a whole host of additional support requirements ranging from organisational development, culture and workforce planning through to design and implementation support for new models of care and commissioning, procurement, governance and evaluation.
A new type of partnership working
Perhaps the most crucial ingredient for STPs to work is stronger relationships between councils, clinical commissioning groups (CCGs) and providers. This is one of the areas where CSUs can play a crucial role. Following the consolidation of CSUs in recent years, we are now adept at working across large geographic areas and are better placed to share learning and best practice from other areas. In STP terms, this allows us to provide objective support, stepping out of the partisan ties which can derail partnership working.
As a fellow NHS organisation, CSUs can also bring confidence to customers that we’re working to the same set of values and fully understand the health and social care sector. Our ability to ‘walk in the shoes’ of each of the organisations involved in an STP can be crucial in facilitating partnership working and navigating a path through some of the trickier issues.
Data and analysis
Operating in this industry, everyone recognises the importance and value of data you can trust and STPs bring new challenges here too. Arden & GEM is well versed in the management and interpretation of data across wide geographic areas. But for STPs, the real success lies in combining several sets of data across primary, secondary and social care and in some aspects this is still a work in progress.
Even where data collection is well established, the level of detail varies according to the type of provision. In prioritising developments in Business Intelligence, we all need to be mindful of where the biggest benefits lie. A balance needs to be struck which gives commissioners enough confidence in the changes they’re making and sufficient rigour to assess the impact, without paralysing progress.
As STPs move forward with ambitious plans to tackle some of the most entrenched health issues in their areas, we must recognise that some changes may not work perfectly from day one. CSUs have a role to play in developing ways to monitor change so that any dip in expected outcomes can be swiftly identified, analysed and put right.
As the pace and scale of change increases, CSUs need to be at the forefront of developing techniques which guide and monitor new innovations and scan for other successes to share. Alongside this, there needs to be a willingness to take collective responsibility and resist the urge to retreat into organisational silos when pressures hit.
Scale and flexibility
Ultimately, as STP bodies seek to confirm their priorities and actions, CSUs need to be ready to provide flexible services which support the strategic and practical requirements of the new plans, as well as maintaining the crucial day job of supporting CCGs. Arden & GEM has already developed an agile workforce to enable us to flex our resources according to customer needs – the STPs are simply an extension of this.
While much of the detail is still to be defined as to how the models of care will emerge, STPs herald an exciting opportunity for CSUs. In our case, it's an opportunity to really make the most of both the breadth of our experience and the scale of our resources, but to an extent, we will all be learning together.
Arden & GEM provides comprehensive planning, evaluation and PMO services to support vanguards and Clinical Commissioning Groups in developing new services. For more details download our brochure: Joined up solutions for integrated care