Letting local systems lead: how the NHS Long Term Plan can deliver a sustainable NHS

NHS leaders’ views on issues that are critical to embedding system working in local areas.

16 November 2018

Read Letting local systems lead External link icon

This report explores NHS leaders’ views on a series of issues that we consider critical to embedding system working in local areas and how they relate to ongoing policy discussions about STP/ICS implementation.

We are calling for action to remove the barriers to effective local system working.

It follows a survey of NHS Confederation members which found that:

  • Six in ten leaders (61 per cent) 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 vast majority of respondents considered that only moderate progress (44 per cent) or a little progress (42 per cent) had been made in implementing the system working approach set out in the NHS Five Year Forward View
  • 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

Based on the findings, and our own analysis of the challenges facing the service, the NHS Confederation is calling for the long-term plan to:

  • Make support for effective local leadership and relationships a priority
  • Focus attention on the key factors that will allow local improvements to health and social care services
  • Shift the focus of regulation from performance management to improvement support
  • Support local systems to strengthen ownership in their communities of the long-term plan vision