Comment / Effective partnership working: the common ingredient

As system transformation takes hold, the common ingredient is effective partnership working – a skill that the finance community has embraced.

With the new 10-year plan for the NHS in development – its centrepiece being a commitment to bring about measurable improvements in population health and to reduce health inequalities – working across systems has never been more important. Sustainability and transformation partnerships (STPs) are developing at different speeds, but all depend on making further progress in integrating health and social care, building on the development of new care models, or creating and embedding integrated care systems (ICSs).

STPs are taking an increasingly prominent role in planning and managing system-wide efforts to improve services. This includes managing the additional capital requirements within overarching STP strategies, STP digital roadmaps and the alignment of commissioner and provider assumptions in meeting constitutional targets.

The NHS planning guidance for 2018/19 gave STPs a formal role as part of the refresh of organisational plans, ensuring provider and commissioner assumptions are credible and aligned. They were also given a role in identifying system-wide efficiency opportunities and reviewing estates across their systems.

Even with the announced funding increases, the NHS faces hard choices about what improvements can be delivered. Ambition needs to be tempered with realism and the system-wide efficiency challenge has never been more important. Finance professionals have a vital role to play in this increased system working.

Keen to be part of the team leading system change, I took on the finance director role for the Staffordshire and Stoke-on-Trent STP, known locally as Together we’re better. The new environment in which we operate has been – and is still – changing rapidly, presenting a new set of challenges and opportunities. Being one of the STPs identified as ‘needing most improvement’ in last summer’s baseline STP progress dashboard, we face some significant challenges. But all health economies are facing similar issues.

In our STP, we have started some great pieces of work and, in common with others, have some excellent individuals who are really keen to rise to the challenge. We recognise that the understanding of what’s required often sits with just a few individuals within the finance team (often the most senior) and so we’re looking at ways to extend the network and engage more widely.

Coalitions of the willing are emerging, the new relationships are developing, the ideas are forming. There is a great opportunity to share the best practice from across the country as this new way of working develops at different speeds, helping those in their infancy to mature and reinforce and support those leading the way. It is important to me to work with and learn from others outside of my STP to enable it to succeed.

I have been working with the HFMA since I joined the NHS 17 years ago, across numerous special interest groups and faculties. The networks we have are invaluable and the support we provide to one another is second to none. Those leading on STP finance do have regular meetings and there are some great sessions facilitated by NHS England and NHS Improvement, but there’s always scope to do more. STPs present a new and challenging role for finance, requiring different mindsets and skills.

Even the most advanced systems have encountered challenges, so having a network to support and encourage learning around this will enable much greater success.