Skip navigation
The Progressive Policy Think Tank

NHS change must be funded properly and championed by ministers to make service fit for the 21st Century

New analysis by IPPR shows financial problems continue to grow and trying to implement STPs without a cash boost is asking the impossible

New analysis by IPPR, the progressive policy think tank, looks at all 44 of the NHS Strategy and Transformation Plans (STPs). It finds that change is needed to modernise the NHS, but with current funding and lack of political leadership it is unlikely they will succeed. The analysis finds that:

  • Every STP area has a deficit, together totalling over £24 billion, at least £2 billion more than Simon Stevens assumed when the process began and he asked the government for £8 billion extra funding;
  • Nearly half (44 per cent) of plans include hospital closures or other major services changes. This is something IPPR argues may be necessary to modernise services but should be driven by saving lives and with real community engagement;
  • There is wide variety in the quality of the plans, with some lacking anything other than broad objectives and aspirations, rather than a detailed plan for change.

Britain, like all advanced countries, faces constant pressure on healthcare demand and costs from a growing ageing population as well as rising treatment costs from new technology.

IPPR argues that urgent action is needed to get this health service reform back on track:

  • An urgent cash injection for both health and care through an NHS tax to make sure changes are not driven by spiralling NHS deficits – otherwise the STPs are simply asking the impossible;
  • Genuine local consultation and democratic accountability for changes to services;
  • Proper political leadership of changes by the Prime Minister and Health Secretary.

Harry Quilter-Pinner, IPPR Research Fellow on Public Services, said:

“The debate on STPs has become dangerously polarised between campaigners who claim they are Secret Tory Plans for cutting the NHS and the government who says they are local initiatives that have nothing to do with them.

“The truth is that the Health Service will have to radically change to deal with spiralling demand from an ageing population and expensive new drugs and technologies. So STPs are vital in keeping the NHS up to date and free at the point of use.

“But on their own they won’t be enough. Put simply the NHS needs more money. IPPR believes we all need to invest a little to change the NHS to make it fit for the future.

“The Prime Minister and Health Secretary will also need to step up and lead NHS change. Hard decisions will inevitably need to be made and without better political leadership this process is doomed to fail.”

Alongside this new analysis IPPR is publishing an interactive map that allows anyone in England to access key facts about the STP for their area. It can be found here: [please note this link is embargoed as per story].



Kieren Walters 07921 403651

Editor’s Notes:

1. The full analysis can be found here.

2. The case for service reconfiguration: There is strong evidence base that for some services, in particular A&E and specialist surgery, concentrating care in fewer locations can save lives. This is partly because it allows people to access highly trained doctors and best equipment, but also because with increased patient numbers comes increased experience and therefore fewer mistakes amongst staff. Likewise, some treatments need immediate access to other services such as intensive care or orthopaedic trauma which can only provided in larger hospitals. This has been demonstrated before, for example in London, where it has been estimated that the recent reconfiguration of stroke services has saved more than 400 lives a year

While much of the focus so far has been on hospital re-configurations, STPs are looking to introduce a much wider and more ambitious set of reforms. Notably, at the heart of the reform agenda is a move to integrate care within the NHS and between health and social care, with clear evidence that this is better for people’s health and (to a lesser extent) for the public purse. Most STPs are actively driving forward this agenda, for example through the creation of new joined up local services - based on success stories such as the Bromley by Bow Centre - which bring together GPs, mental health services, social care, community nursing, sexual health services, diagnostics, third sector services and even housing and employment services.

3. 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, it covers the economy, work, skills, transport, democracy, the environment, education, energy, migration and healthcare among many other areas.