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Background to sustainability and transformation plans (STPs)

Sustainability and transformation plans (STPs) were announced as part of the NHS planning guidance in December 2015. STPs are bringing together local leaders in health, local government and patient representation to plan how services will evolve and become sustainable between 2016 and 2021.

STPs have been developed to accelerate the implementation of the Five Year Forward View published in October 2014. An important feature of STPs will be health service providers and local authorities working together to ensure that services are delivered across the whole of the local health and care economy and ensuring that the delivery of care is not dominated by individual organisational priorities. To ensure the plans are delivered at a local level 44 footprint areas have been established. 

STP footprints

These footprints have an average population of 1.2 millon, with the smallest 300,000 and the largest 2.8 million. Each area has a named individual to the lead the development of the plans, the majority of these are from Clinical Commission Groups (CCGs) but some are leaders of NHS trusts or senior local government officials. STPs have no formal organisational framework all work is being done in addition to organisations day to day activities.

The initial NHS England guidance set out 60 questions to be considered when developing plans. These cover three areas, improving quality, improving health and wellbeing and improving efficiency of services. Each STP footprint has been asked to design a plan that meets the key priorities for their locality, and include better integration with local authorities

STPs offer a real opportunity to ensure that care is delivered in a joined up way and ensure that the needs of local populations are reflected in service delivery; however this will be delivered against the backdrop of sustained financial pressure on the NHS and social care.


The timeline for developing STPs and the process for approving them has been unclear. The original deadline for STPs to submit plans to NHS England and other national bodies was the end of June 2016, but most plans will be developed further and available by the end of December 2016.

From April 2017 STPs will become the single application and approval process for accessing NHS transformation funding.

From April 2017 STPs will become the single application and approval process for accessing NHS transformation funding, with the best plans set to receive additional funds more quickly.

Why should physicians get involved?

STPs are likely to recommend changes to the way hospital services are delivered. The RCP believes STPs should be planned, implemented and delivered with clinical input at their core. To make a true success of joint working and collaboration frontline staff, clinicians and their teams need be able to offer insight into how frontline services can be improved to ensure that the NHS delivers high quality and sustainable care.

If STPs are to be successful they must involve physicians to effectively capture the expertise of clinicians who are best placed to advise how high quality patient care can be delivered. Each plan should reflect the particular needs of that locality. Physicians are best placed to comment and hold STPs to account. You should get involved in your local area.

How can physicians get involved?

  • Identify your STP footprint and lead - Use our guide at the bottom of this page to find your STP and contact details of the lead.
  • Assess your local plan - If your plan has not yet been released contact your lead to find out if you can contribute and advise before the plan is released.
  • Feedback to your STP lead - Details of public and clinical consultations will be made available as plans are released. If your area’s plans have not yet been made available contact your lead directly. You should consider what your STPs plans will mean for your patients. Local insight and expertise will have the greatest influence on developing individual STPs.
  • Feedback to the RCP - We will be collating feedback from physicians to identify national trends. The key questions we would particularly like members to consider are:  
    • does the plan seem appropriate for your area;
    • do you think there has been enough clinical input;
    • are there any aspects you think are good; any that you are concerned about it?
    • Will the proposals improve the quality of patient care

Please send any feedback to STP@rcplondon.ac.uk.


London region 225.12 KB
North region 268.93 KB
South region 238.55 KB