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Less than a quarter of local politicians are confident that major NHS plans to reshape local health and care services will succeed, according to a new survey by the Local Government Association.

STP illustration


The LGA, which represents more than 370 councils in England and Wales, has found that the majority of councillors responding to its poll do not feel they have been involved with shaping, commenting on or approving the NHS’s 44 sustainability and transformation partnerships (STPs).

STPs are aiming to redesign and overhaul local health and care services to cope with increasing patient demand and will focus on treating patients in the community and away from hospitals.

On the second day of the LGA’s Annual Conference in Birmingham, council leaders are warning that if the STP plans proceed as they are, then they will not work.

Key findings of the LGA survey, published today, are:

  • While more than 90 per cent of responding councillors know about STPs, just 21 per cent said they had felt sufficiently engaged in their STPs
  • Under 25 per cent of responding councillors are confident that their STP will deliver on its objectives or bring benefits to their local communities
  • Not a single respondent had reported that their full council had been “very engaged” in their STP

The LGA is calling for the NHS to act now to involve councillors as equal partners in STPs.

It says that STPs should be more democratically accountable through local health and wellbeing boards, which should also be given a legal duty to sign off the plans.

Health and wellbeing boards bring together political, clinical and community leaders to plan how best to meet the health and wellbeing challenges of their local population.

Chairman of the LGA’s Community Wellbeing Board, Cllr Izzi Seccombe, said:

“Many councillors have been disappointed by the unilateral top-down approach of the NHS in some of the STP areas. As our survey results show, the majority of local politicians who responded feel excluded from the STP planning process.

“If local politicians and communities are not engaged then we have serious doubt over whether STPs will deliver on their objectives and bring benefits to communities.

“We are therefore calling for urgent action at national and local level to involve councillors as representatives of their local communities in a meaningful way in all aspects of STP development.

“The LGA is keen to work with NHS England to improve engagement and develop STPs in accordance with the democratic structures of local government.

“For STPs to work, they need to be a genuine partnership between clinical, professional and political leaders, driving forward the change of local health and care for the better.”


At least one senior elected member from each of the 152 single tier and county local authorities in England was directly invited to undertake the survey. A small number of additional respondents were also engaged through circulation of the survey in relevant online publications, which included councillors from two district councils. In total the survey was completed by 81 respondents from 66 single tier and county councils and two district councils. Eleven councils gave multiple responses, with two councils giving three separate responses.

Source: https://www.local.gov.uk/about/news/lack-confidence-stps-councils-warn