There is a tight timetable for the delivery of the sustainability and transformation plans ("STPs") across England and it is apparent that considerable thought needs to go into the governance and decision making arrangements for these plans to avoid the risks of challenge.

The opening question is one of scope. Who needs to participate? Does it include primary care providers and if so how? Does it include private sector providers operating within the relevant area? If not, why not?

Whilst a joint board involving the various stakeholders is certainly possible, given the inclusion of both NHS commissioners and providers, to say nothing of the local authorities there is no general power to form a joint committee covering all stakeholders. Organisations need to consider carefully how any joint board will operate, and how decision making flowing from that will be taken. Ultimately each stakeholder needs to have in place a mechanism for approving or otherwise the proposals either through delegation to the relevant joint board member, or by taking it back to the relevant decision maker.

We can help design and adapt schemes of delegation and ad hoc arrangements for this to help you ensure that your decision making is robust. Further governance issues will arise in order to effectively manage conflicts of interest and the issues relating to confidential information especially in connection with forward planning for services where there is direct competition between organisations that may be participating in the STP process. Again we can help support you in terms of identifying what information may be shared and whether a non-disclosure agreement needs to be put in place to protect the information shared within the STP scheme.

Finally organisations need to have an eye to the requirements for public consultation around service change. The STP plans, given the timescale are unlikely to have been the subject of full public consultation and we can advise on how to manage this tension and indeed to advise on the process for consultation and final decision making in order to achieve robust plans for service change.

If you need further information please contact David Owens, Judith Barnes, Michael Boyd or Madeleine Moore.

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