NHS England has now confirmed the senior leaders who will oversee 44 ‘footprint’ areas in which health and care organisations and communities will work together to develop local blueprints for improved health, care and finances over the next five years.

The new approach seeks to ensure that health and care services are planned by place rather than solely around individual institutions, over a period of five years, rather than just a single year. 

Central to this are the design and delivery of Sustainability and Transformation Plans (STPs), which must show clearly how each area will pursue the ‘triple aim’ set out in the NHS Five Year Forward View – improved health and wellbeing, transformed quality of care delivery, and sustainable finances.

NHS England has also now published a map of the 44 areas after frontline health care leaders defined the most locally appropriate boundaries, recognising that footprints will not cover all planning eventualities, and that different areas will have different needs. Populations range from 300,000 (in West, North and East Cumbria) to nearly three million people (in Greater Manchester).

An STP fund of some £2.1 billion has been set aside for the financial year 2016/17, which will rise to £2.9 billion in 2017/18 and to £3.4 billion in 2020/21.

“The STP process signals a change in approach to planning that is very welcome - from organisation to place and from short-term survival to medium-term sustainability,” noted NHS Confederation chief executive Rob Webster. “The key now will be to provide a robust package of support for all 44 leaders to be able to work in partnership across their local systems.”

“National bodies have an important role to play in supporting and enabling local leaders to foster critical local relationships that will determine the fate of these plans. What must be avoided is excessive control from the centre, which would stifle local ambition to transform local health and care services,” he stressed.

“Improvement within the NHS needs organisations to work strategically within their local health economy,” noted Jim Mackey, chief executive designate of NHS Improvement. “We need the Sustainability and Transformation Plans to encourage organisations to work together, to think boldly and to work out how change - no matter how radical - can best be achieved to meet the major challenges we face”.

The senior leaders selected to oversee the footprint areas include: Amanda Doyle chief clinical officer of NHS Blackpool Clinical Commissioning Group (CCG) and co-chair of NHS Clinical Commissioners (Lancashire and South Cumbria footprint); Sir Andrew Morris, chief executive of Frimley Health NHS Foundation Trust (Frimley Health footprint); Angela Pedder, chief executive of the Royal Devon & Exeter NHS FT (Devon footprint); David Sloman, chief executive of the Royal Free London NHS FT (North Central London footprint); David Smith, chief executive of NHS Oxfordshire CCG (Buckinghamshire, Oxfordshire and Berkshire West footprint); Sir Howard Bernstein, chief executive of Manchester City Council (Greater Manchester footprint); Mark Rogers, chief executive of Birmingham City Council and President of the Society of Local Authority Chief Executives (Birmingham and Solihull footprint); and Toby Sanders, accountable officer of NHS West Leicestershire CCG (Leicester, Leicestershire and Rutland footprint).