TY - JOUR T1 - Sustainability or transformation? Without additional funding, STPs are unlikely to deliver both JF - British Journal of General Practice JO - Br J Gen Pract SP - 496 LP - 497 DO - 10.3399/bjgp17X693197 VL - 67 IS - 664 AU - Stephen Gillam Y1 - 2017/11/01 UR - http://bjgp.org/content/67/664/496.abstract N2 - Who now remembers the fanfare that greeted the Five Year Forward View (FYFV)?1 It seems so long ago: a pre-Brexit age of innocence when politics was at least predictably unpredictable. Launched in October 2014, the ‘FYFV’ was billed as Simon Stevens’s bid to reconfigure the NHS. It marked a shift away from competition as a means of health service improvement to a more collaborative approach. Sustainability and transformation plans (STPs) were the vehicle through which NHS organisations and their partners were to develop new models of care in their area. Over halfway through those 5 years, what has been achieved and what does the future portend for STPs?From the outset, the production of STPs was tightly controlled from the centre; 44 geographical areas (‘footprints’) were defined, covering the whole country. The King’s Fund has described the production process based on detailed interviews in four sites.2Much creditable work has been done generating innovative plans over a short period.3 In time-honoured fashion, NHS England has pump-primed 50 ‘vanguard’ sites as exemplars transmitting early experience. Of the proposed care models, most interest from the primary care perspective has focused on multispecialty community providers (MCPs) and primary and acute care systems (PACS), which feature in more than half the vanguards.MCPs form extended primary care group practices through federations, networks, or single organisations to provide a wider range of care using a broader range of professionals. They may, for example, employ consultants or take them on as partners. PACS are a new variant of ‘vertically integrated’ care allowing single organisations to provide GP, hospital, community, and mental health services.Compared with their 2014/2015 baseline, both PACS and MCP vanguards have seen a … ER -