Sustainability and transformation partnership (STP) collaboration

The COVID-19 pandemic has had a significant impact on the way we access healthcare. Both the prominence of the virus within the acute setting and the shift to virtual services in primary care have had a dramatic impact on patient behaviour and the way that treatment is delivered.

Learning from these changes could lead to an acceleration of the NHS workforce expansion plans, particularly those which enable delivery in different settings that is required in order to achieve the programmes cited in the NHS Long Term Plan.

The disruption caused by the pandemic has placed even greater emphasis on the intended shift to preventative care, with more areas of service being delivered in the community and through evolved primary care networks (PCNs). Now seems the right time to explore the changing composition of a workforce that is deployed across an entire STP or integrated care system.

There are many advantages in collaboration across a bigger footprint. All healthcare provisions within an STP will benefit from the improvements in scale of workforce and increased flexibility from a more collaborative approach.

• STP-level collaboration presents further opportunities for the deployment of skilled clinical workforce from both bank and agency workers across acute, primary and preventative healthcare e.g. primary care outpatient clinics
• STP-level collaboration and workforce solutions also provide the scale required for further investment into digital services. Such digital solutions will enable the workforce as well as provide patients with access to a broader set of clinicians at a time that suits them, thereby putting staff to work in new ways. Examples include access to digital therapies in mental health or remote diagnostics in primary care
• Collaboration provides opportunities for major new programmes of work to release time to care

Workforce operating at an STP level is a key objective of the NHS Interim People Plan. The NHS Long Term Plan is clear that integrated care systems should be the main organising unit for health services by 2021. Specific workforce priorities can differ significantly by area and it is vital for local health and care organisations to collaborate in order to shape their local workforce.

Shifting acute workforce into primary care and sharing staffing banks across an integrated care system opens numerous opportunities and enables more innovative care delivery. We have seen success with clinical insourcing services where PCNs have relied on an insourcing provider to undertake digital dermatology clinics in the community to help address waiting lists. Similarly, it is increasingly common for ECG and echo scan results to be diagnosed remotely and for patient consultations to be delivered remotely using digital channels. These are likely to become the preferred approach in future.

The pandemic has significantly impacted both social care and mental health. It is widely anticipated that demand for these services will become even greater in the future.

Before the pandemic, mental health providers faced considerable demand and often struggled to meet waiting list targets due to the volume of referrals. Early uptake of digital therapies and remote services had already begun to play a significant part in service delivery prior to the pandemic and have rapidly accelerated since, putting the workforce to work in new ways.

Further insight

This is the fourth in a series of seven articles part of our ‘NHS workforce provision in a new world’ report. To access part five, where we look at a new operating model for workforce, keep an eye on our LinkedIn.