Sustainability and Transformation Plan


Our STP is one of 44 ‘footprints’ in the UK

There are 14 partner organisations involved with our STP

Together we serve a local population of over 920,630 people

Our footprint covers 110 GP practices

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Since April 2016 leaders of health and care organisations from Bath and North East Somerset (B&NES), Swindon and Wiltshire have been working together to develop a ‘Sustainability and Transformation Plan’ (STP).

This collective work aims to improve our local population’s health and wellbeing, to improve service quality and to deliver financial stability.

We are developing a joint approach that will help to deliver the aims of the  NHS Five Year Forward View and is in line with other important national guidance such as GP Forward View, Mental Health Taskforce Report and National Maternity Review.


The B&NES, Swindon and Wiltshire (BSW) plan is being led by James Scott, Chief Executive of Royal United Hospital in Bath, a position he has held since 2007.  James oversees and coordinates a team drawn from the leaders of each of the health and social care organisations included in our STP ‘footprint’ area.   During this time, James is continuing with his responsibilities as CEO of the RUH.

The BSW plan brings together our three hospitals (Royal United Hospital, Great Western Hospital and Salisbury Foundation Trust), the three Clinical Commissioning Groups;  B&NES, Swindon and Wiltshire Councils, South West Ambulance Service and Avon and Wiltshire Mental Health Partnership Trust.  The providers of our community services – Wiltshire Health and Care, Seqol and Sirona and the Wessex Local Medical Committee (representing GPs from across the BSW area) complete our organisational grouping.

Working together to cover a combined population size of approximately one million people, the BSW grouping will bid for and receive a transformation fund from 2017/18 onwards, which will be used to pay for health and social care services for people living in our area.

James Scott, Chief Executive at the Royal United Hospitals Bath NHS FT

James Scott, Chief Executive at the Royal United Hospitals Bath NHS FT

There are growing pressures on the health and care system, nationally and locally.  The proportion of older people is rising and there are more people living with complex conditions.  This is contributing to an increased demand for services.

Overall across B&NES, Swindon and Wiltshire the standard of health and care services is very good compared to other areas in England.

But some challenges remain. Our hospital Accident &Emergency (A&E) departments are under pressure, in some areas patients are waiting too long for GP appointments and there are gaps in quality with some parts of our region benefitting from better health and care services than others.  Additionally there are increasing financial pressures.  Across all our local health organisations there was a collective end of year deficit of £6million for 2015/16 and this will rise to £337million at the end of 2021 across our combined area if we do nothing.

So we are working on a collective plan to drive greater efficiency and improvements in quality across the health and care system. For services to be sustainable, we also need to get better at preventing disease, not just treating it, and encourage everyone to take responsibility to manage their own care.

At the end of June, we submitted some early proposals to NHS England and we will submit more detailed plans at the end of October. There are five key priority areas that are emerging. These are:

  • To provide improved person-centred care by strengthening and integrating the specialist services that support primary care
  • To shift the focus of care from treatment to prevention and proactive care
  • To redefine the ways we work together as organisations to deliver improved individual/patient care
  • To ensure we offer staff an attractive career and build a flexible, sustainable workforce
  • To strengthen collaboration across organisations to directly benefit acute and urgent care services

Over the coming months STP leaders, in collaboration with Healthwatch, look forward to engaging with the public, patients, carers and the wider heath and care workforce to shape and develop the plans further and build a shared vision for high quality, sustainable services.

Updates on our STP will be shared at CCG board meetings in public and at our AGM. A wider programme of public engagement will commence in the autumn and more information on this will be available here shortly.

In the meantime if you have any questions or feedback, please get in touch by email to or contact your local Healthwatch office.