Martha Everett

But the plans, and the very fact that some have been published ahead of a full review by NHS England and NHS Improvement, also demonstrate how the process of making changes on this scale is not a linear or technical process but a swirl of highly emotive relationships. STPs have run into issues such as insufficient clinical engagement, patient engagement, a lack of appropriate governance and legal footing, and a challenge to achieve the right level of focus on both social care and health care services.

However, it would be wrong to only focus on the challenges of the STP process without reflecting on how local areas have come together in a relatively short period of time to radically rethink what the future focus of the NHS and social care systems should be. We have already seen boards of acute providers speaking less about income growth, repatriating services and expanding capacity, and instead spend increasing time discussing how extensivist models of care and wellness promotion underpinned by risk-share contracts can deliver more for patients and service users.

We all know that a healthy environment and promoting a wider range of healthy life choices mean that people live longer in better health. We know that people in the most deprived areas of the country die younger than their wealthier counterparts. We know that a host of social and economic factors have a significant impact on quality of life. To meet these needs local health and care economies are now supporting staff to lead healthier lives, investing in apprenticeship schemes to boost local employment, and partnering with housing associations to promote healthier living environments.

The conditions are now emerging for a health and care service that is based upon the principles of a wellness service rather than a treatment service. We have a planning mechanism to bring different parts of the system together, we are investing in the technology to knot disparate organisations and data together to form holistic views of patients’ needs, and we are developing payment systems that reward collaborative working and health promotion.

It would be wrong to underestimate the challenges we face as we navigate through the current strategic ferment the NHS finds itself in. But the prize at the end of this ferment is a service that both maintains accessible high quality treatment for patients, and promotes the good births, healthy lives and wellbeing our citizens deserve.

Transformation is the focus of one of the strands at the the annual conference and exhibition. Find out more about the strand programme, and book your place to join us in Birmingham on 29-30 November