Lack of clear STP governance could ruin NHS overhaul

More than half of NHS finance directors will not prioritise targets set out in regional plans to stabilise the future of the NHS because the governance structure is unclear, according to a leading healthcare association.

In the Healthcare Financial Management Association’s latest opinion survey on NHS finances, researchers found that 62% of finance directors would prioritise their own organisation’s priorities over those of the local sustainability and transformation plan (STP).

More than half of NHS finance directors will not prioritise targets set out in regional plans to stabilise the future of the NHS because the governance structure is unclear, according to a leading healthcare association.

In the Healthcare Financial Management Association’s latest opinion survey on NHS finances, researchers found that 62% of finance directors would prioritise their own organisation’s priorities over those of the local sustainability and transformation plan (STP).

The report suggests this is because the authority and accountability of STPs is still unclear, as 72% of finance directors are unsure on how STPs relate to the statutory duties of NHS boards or to the 2016 NHS financial control totals.

The report added that without clearer governance, finance directors will prioritise the financial position of their own organization, making it “likely to undermine the ability of STPs to generate genuine transformation”.

However, the finance directors, including CCG chief financial officers and provider finance directors, were found to have a “broad acceptance” of STPs.

But the report, which draws on the responses of 128 provider trusts and 73 CCGs, also notes that only 17% of CCG chief financial officers believe the STPs to be deliverable.

Meanwhile, just 6% of trust finance directors feel the same.

Chris Hopson, chief executive of NHS Providers, has previously warned that the STPs are “undeliverable” because they are “vastly over ambitious”.

Paul Briddock, director of policy at HFMA, said the lack of clear governance is “causing some angst” where priorities conflict.

But he added: “Given it is early days, many organisations are yet to find a balance and there are clearly still issues that will need to be worked through, but doing this in an open and transparent manner will be key to achieving the success we need to see across the NHS.”

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