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The Progressive Policy Think Tank

New law needed to make a success of STPs

New report from think tank IPPR says Queen’s Speech missed opportunity to face up to NHS crisis

The NHS is facing one of the most challenging periods in its history. A combination of rising demand and stagnant funding growth means that the service is facing a funding gap of more than £22 billion over the coming years. Meanwhile, the pressure on the social care system is even more severe with the raising of eligibility thresholds and cuts to social care budgets.

Sustainability and Transformation Plans (STPs) are one of the government’s responses to this problem. The plans focus on decentralising power, investing in leadership and on local health and care organisations coming together to overcome the silos created by the 2012 Health and Care Act.

However, many challenges stand in the way of STPs realising their vision for improved health outcomes and greater efficiency. IPPR is setting out recommendations to allow STPs to deliver real change to England’s health and care system:

  • Amending the law to better enable the pooling of budgets and commissioning functions locally; to give regional bodies a formal role in the system and put into effect place-based health and care;
  • Introduce a new ring-fenced ‘NHS tax’ funded by a rise in national insurance. This could raise up to £16 billion over the next five years. This should be channelled through the STP fund to help close the funding gap;
  • National leaders – especially the Prime Minister and the Secretary of State for Health – lead a visible and high profile public engagement exercise to make the case for NHS reform.

Harry Quilter-Pinner, Research Fellow, said:

“The 2012 Health and Care Act created silos through the dissolution of primary care trusts and the strengthening in legislation of the provider-commissioner split which have not made reform easy.

“It is an open secret that STPs are an attempt to undo some of the damage caused by the Health and Social Care Act, however it is difficult to do this without the use of legislation.

“IPPR is arguing that part of the solution to the problems preventing STPs from driving real change in the system must involve wrapping governance around STPs both to give them real power but also to make them more accountable for how they use this power.

“Amending existing legislation and creating new national legislation would move away from competition to collaboration.”



Kieren Walters 07921 403651 [email protected]

Editor's Notes:

  1. Sustainability and Transformation Plans (STPs): What, why and where next? can be found here:
  2. IPPR aims to influence policy in the present and reinvent progressive politics in the future, and is dedicated to the better country that Britain can be through progressive policy and politics. With nearly 60 staff across four offices throughout the UK, IPPR is Britain’s only national think tank with a truly national presence.

    Our independent research is wide ranging and covers the economy, work, skills, transport, democracy, the environment, education, energy, migration and healthcare among many other areas.