Sustainability and transformation plan

In March 2016 NHS England organised the geographical division of England into 44 Sustainability and transformation plan areas (or footprints) with populations between 300,000 and 3 million, which would implement the Five Year Forward View. These areas were locally agreed between NHS Trusts, local authorities and Clinical Commissioning Groups. A leader was appointed for each area, who is to be responsible for the implementation of the plans which are to be agreed by the component organisations. They will be "working across organisational boundaries to help build a consensus for transformation and the practical steps to deliver it".

This geographical configuration differs in some respects from previous arrangements - Regional Hospital Boards, Regional Health Authorities and Strategic Health Authorities - because the configurations have been locally agreed, rather than imposed from the centre. They also vary very considerably in size, the largest having more than ten times greater population than the smallest.

Three of the leaders are from local government: Sir Howard Bernstein, the chief executive of Manchester City Council, David Pearson the director of adult social care at Nottingham City Council, and Mark Rogers, the chief executive of Birmingham City Council and president of the Society of Local Authority Chief Executives and Senior Managers. The remainder are NHS managers.

The NHS planning guidance for 2016-17 states: “For many years now, the NHS has emphasised an organisational separation and autonomy that doesn’t make sense to staff or the patients and communities they serve… System leadership is needed.” It also suggests that the financial problems of individual organisations are no longer critical. What is important is the financial situation of the organisations in each area considered together. Each area is required to produce a Sustainability and Transformation Plan by end of June 2016.

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