This article illustrated well the myriad of challenges facing STP's around the country and how and when health and LG partners engage. This is a good challenge to the fashionable view in management that it's all about people rather than systems and structures.
It strikes me if you cut to the chase- then we have incompatible financial systems and decision making processes. People can get on like a house of fire but if the system says no then progress will always be at the margins. If people are only interested in protecting their fiefdoms- progress is glacial. We need a fundamental review of public services in places which are financed and managed in a consistent way.
Leicester City Council has threatened to raise formal concerns with Leicester, Leicestershire and Rutland STP over proposals to evolve into an accountable care system, HSJ has learned. A paper entitled “Moving Towards Accountable Care in LLR” was presented to the board of University Hospitals of Leicester Trust last week, which said “this is not about ‘whether’ an ACS [is established] but ‘when’.” Councillors said they have been involved in ‘zero discussions’ about the ACS However, the three local authorities have criticised the absence of detailed plans to tackle the £399m financial gap outlined in the sustainability and transformation plan, and the failure to establish accountability and governance frameworks. There is also concern over the performance of the acute trust, which has been ordered to improve by NHS Improvement after some of the worst accident and emergency performance in the country.