The south west London Sustainability and Transformation Plan – a manifesto not a detailed blueprint

Dr Naz Jivani, Kingston GP and Chair of Kingston Clinical Commissioning Group talks about our plans for the NHS in south west London and explains what the south west London Sustainability and Transformation Plan is – and isn’t.


One of the things I’ve noticed when talking about our Five Year Forward Plan for south west London is that some people think the plan is a detailed blue print or master plan setting out a series of measures that will be implemented in the next five years. Nothing could be further than the truth. The Five Year Forward Plan – or STP – is simply the collective view of the area’s six clinical commissioning groups (CCGs), hospitals, mental health trusts and community services about how we can collectively get to grips with the challenges we face with  the help of local councils.

As a result, the Five Year Forward Plan  is actually a series of plans rather than a single one, with various proposals and work streams at different stages of development.

Some of these plans – such as the proposal to develop multi-disciplinary locality teams to support local communities – are already being developed in each borough. Others, such as which services should be provided in the community  and which in each hospital, need further consideration and discussion. In that sense, what we have jointly produced is something that is more like a manifesto than a detailed blueprint.

The overarching challenges during the next five years are:

  • Prevention – we are often better at treating people once they are ill, than helping them to stay well
  • Right care in the best setting – too many people end up in hospital when they do not need to – we could treat people quicker and more effectively outside hospital in many cases
  • Workforce – hospital staff are spread over large number of small sites and there is a shortage of key clinicians in both hospital and primary care services (e.g. GPs nurses, some hospital specialists)
  • Condition of buildings – some of our buildings are now very old and in poor repair
  • Funding – due to all of these challenges, flat funding and more people needing more care, the pressure on finances is growing and this will impact the quality and sustainability of services if we do not act now

So what are the benefits to people when all we hear on TV is how much pressure the NHS is under, on-going staff shortages and savings programmes?

A summary of benefits in our five year plan include longer GP opening hours, greater support for the elderly, better hospital care, services closer to people’s homes and faster more effective treatment of cancer.

The realisation that the NHS’s poor health is the mirror image of the general population is the first step towards solving the problem. The NHS has certainly reached a point where it has to change and this will mean changes in the way we use it too.