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Sustainability and transformation plans (STPs)

As part of the Five Year Forward View, every health and care system in England has been asked to create their own local place-based plan for the next five years.

These are referred to as Sustainability and Transformation Plans or more commonly as STPs.

We have published a comprehensive analysis – Delivery costs extra: can STPs survive without the funding they need? – of the STPs process so far as well as further information on each individual plan and a glossary of terms used.

It is important that you are holding your local leaders to account over these plans. We've compiled a list of questions for you to ask. Find details of who to contact in the map below.

Eight STP footprints have been announced as Integrated Care Systems, formerly known as Accountable Care Systems.

Find out more about Accountable Care Organisations (ACOs) and Integrated Care systems (ICSs)

Download the documents:

  1. Further information on each individual plan (PDF)
  2. Delivery costs extra: can STPs survive without the funding they need? (PDF)
  3. Accountable Care Organisations - member briefing (PDF)
  4. List of questions to ask (PDF)
  5. Glossary of terms (PDF)


Keep up to date with recent developments

The BMA continues to analyse the plans and their impact on the NHS as more information about them is released.

Read our STP news stories

Read our STP press releases and media coverage

Read the STP blog: Delivery costs extra


Find out what is happening in your area

There are 44 STPs across England. Click on where you are on the map below to find a summary of the key facts and figures, a link to your plan and information on how to engage.

View a larger version of the map for more details

Digital boundary information contains National Statistics data © Crown copyright and database right 2017. Contains OS data © Crown copyright and database right 2017


Know the key facts about STPs

  • They are place-based plans, which cover an entire health and care system rather than a single organisation
  • They are multi-year, which cover the period from October 2016 to March 2021
  • Each footprint has been asked to identify 3-5 critical decisions to prioritise
  • They are umbrella plans that cover a range of delivery plans, different geographies and types of services
  • The plans must show how they will achieve sustainable financial balance by 2021
  • The plans are expected to set out how the local area will implement a number of national priorities, such as seven day services, improving cancer outcomes and a paperless NHS.


FAQs on sustainability and transformation plans

  • What are STPs?

    Sustainability and Transformation Plans (STPs) are five year plans detailing how local areas will work together to implement the Five Year Forward View and achieve financial balance by 2020.

    In order for these plans to be developed England has been divided into 44 STP geographic 'footprints' made up of NHS providers, CCGs, local authorities and other health and care services. These organisations will work together to create a plan based on local health needs.

    STPs are important because they will be the main route to both funding and service change from 2017/18.


    STP footprints

    There are 44 STP footprints across England. Each footprint covers NHS providers, CCGs, local authorities and other health and care services, who are expected to work together to produce the STP.

    Senior figures from organisations within the footprint have been appointed to lead - see the list on NHS England's website.


    BMA council chair Dr Mark Porter gives an overview of STPs and describes the BMA's position in the video below:

  • What is the timeline?

    • April 2016: Footprints submitted their initial STPs.
    • May 2016: Conversations took place between footprints leads and leaders from the health ALBs (arms lengths bodies).
    • 30 June 2016: Second deadline for submission.
    • July 2016: Regional conversations between footprint leads and leaders from the ALBs.
    • 21 October 2016: Final deadline for submission.
    • October - December 2016: Plans expected to be published.
    • Early 2017: Consultation on plans expected to take place.
  • What's happening locally and nationally?

    In your area

    Find out more about what is happening in your area, see our regional reconfiguration and integration section.

    You can also access contact details of your BMA regional coordinator who will be monitoring developments in your area.


    Across the nation

    To get an overview of the key issues at a national level, contact our health policy team.

    We have good relationships with policy leads nationally and are lobbying for you to ensure that there is genuine clinical engagement across all branches of practice, and that local clinicians are consulted in the development of any planned changes.

    You can also visit NHS England's website for more STP support and FAQs.

  • How can I get involved?

    It is crucial that doctors and other key stakeholders engage in and influence the plans as they develop. While there is national direction and oversight of STPs, they are being developed locally.

    Use these steps to take action in your local area.

    1) Find out the best way to get involved by making contact with your:

    • STP lead
    • LMC (local medical committee)
    • LNC (local negotiating committee)
    • industrial relations officer


    2) Be prepared to ask questions

    We've compiled a list of helpful questions you can ask your STP Lead.

    Download key questions (PDF)


    3) Better strategic planning

    STPs will bring together all previous transformation proposals under one umbrella and therefore should encourage more strategic planning across the footprint.

    The footprint based nature of STPs means that the implications will vary depending on which area of the country you work in.

    With this in mind, there are a number of opportunities for doctors from STPs:

    • more opportunities to work with colleagues across disciplines
    • reduced workload pressures from improved technology and more self-care
    • better evidence based decision making
  • What are the survey results?

    STPs could offer an opportunity to help develop health policies more suited to local need.

    However, our recent survey shows that doctors have serious concerns about how some of these plans have been put together. 

    View the infographic to see the results