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Flagship STPs force rethink of ICS combined control totals

Why have top STPs rejected plans for combined control totals across ICSs?

Leaders of some of NHS England’s flagship health economies are reported to have rejected proposed terms for signing up to system-wide financial control totals.

NHS England and NHS Improvement are said to be open to finding different solutions to the issue and to be looking again at how combined financial targets can be made to work.

Planning guidance published by NHS England and NHS Improvement in early February said 10 sustainability and transformation partnerships (STPs) designated to become integrated care systems (ICSs) would produce joint operational plans for the financial year.

These would include combined financial targets for local organisations linked to the sustainability and transformation fund payments.

However, sources across the ICS areas have said that they had not accepted either of two options for achieving joint financial controls, saying that the financial risks outweighed the benefits for organisations.

An individual involved in the discussions said providers and commissioners are unwilling to risk losing sustainability funding because a neighbouring trust or clinical commissioning group fails to meet its plan.

Combined financial targets are regarded as central to delivering integrated care and system planning within health economies.

In a statement to HSJ, NHS England said the first ICSs are due to go into operation in the next few weeks, in line with the planning document.

Further information

HSJAdvanced health economies reject terms of ‘system control totals’

NHS England: Refreshing NHS plans for 2018/19