Local systems must lead long-term plan

A new report has argued for the NHS long-term plan to bring about ‘breakthrough’ in the development of local health and care systems by minimising central control.

Based on the views of NHS Confederation members, Letting local systems lead: How the long-term plan could deliver a more sustainable NHS is calling for a focus on tackling the barriers to local system working as NHS England prepares to publish its blueprint for the coming decade.

According to the paper, 61 per cent of health leaders agree that sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) represent the right approach for partnership working between the NHS and local government, but the majority of respondents considered that only moderate or little progress had been made in implementing the system working approach set out in the NHS Five Year Forward View.

Furthermore, when asked what would make a difference, local leaders identified better local partnership working, improved engagement with staff, patients and communities, more effective local governance and a more supportive oversight regime.

The NHS Confederation is therefore calling for the long-term plan to make support for effective local leadership and relationships a priority and focus attention on the key factors that will allow local improvements to health and social care services. Furthermore, the plan must shift the focus of regulation from performance management to improvement support and support local systems to strengthen ownership in their communities of the long-term plan vision.

Niall Dickson, NHS Confederation chief executive, said: “We recognise we are calling for increased freedom for local systems at a time when the health and social care service faces significant challenges – and that this may feel counterintuitive.

“But if the logic of the Five Year Forward View and the STP/ICS movement is that the serious systemic problems facing the service will only be addressed via close partnership working at a local level, it is vital every effort is made to make these local approaches successful. Otherwise, we risk stifling local solutions by excessive top down control.”