• To cut a projected 2020/21 deficit of £415 million to £50 million;
• to reduce non-elective admissions, A&E attendances and enhance hospital discharge processes;
• to increase integration in care and create localised teams to deal with physical, mental and social care;
• to target lifestyle risk factors (e.g. alcohol, obesity) to improve the population's health and secondary prevention preventing unnecessary escalation to higher acuity care settings;
• in general, the aim of the STP is to reduce use of the acute sector and move care closer to home.

Like other areas the STP aims to transfer services out of hospital and into the community. The concern is that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.

Under NHS England plans all STP areas will develop into Integrated Care Systems (ICS), previously known as Accountable Care Systems (ACS). This is a new model of care that aims to integrate hospital, community and social care and could involve a new type of contract and capitated (i.e., fixed budget) funding. For further details see our pages on New Models of Care and Accountable Care Organisations.

The STP's aim is that one in five patients who currently go to hospital will be cared for in community instead by community health services and GP surgeries. The STP continues a process of community hospital closures that began in 2014, with the closure of Lowestoft Hospital, since then Southwold hospital has also closed.

The most recent closure is of the Patrick Stead Hospital in Halesworth; the buildings sold will be sold. Some services currently provided at the hospital, such as phlebotomy, therapy services and diabetic eye scans, are being moved to a new location, all in-beds, however, will be lost. According to a report in March 2018, the services will be moved to the Raynor Green Resource Centre, a centre for social day care services for people with dementia, multiple sclerosis and stroke. A public consultation on the closure of the hospital was almost entirely negative about the plans. The four week consultation began in early February 2018. As part of the change Norfolk and Waveney CCG will no longer be funding the social care services at the Raynor Green Resource Centre.

Hospital budgets must save £26 million while being given just £5.3 million by 2020/21. They hope to save £4 million by reducing A&E attendances by 20%.

Within the STP, mental health is the only area of the health and care system getting more money overall with a £14 million investment but the service will have to make £8.4 million of savings by 2020/21.

The STP has ensured that social/community care will get an investment of £18.8 million, but social care alone needs to make cuts of £45.5 million.

Overall, GP surgeries, social care and community care will have to make savings of £56 million, the largest amount of any area, while getting an investment of £33 million by 2020/21.

The STP has said that the prevention service which encourages people to live more healthy lifestyles will be given £4.2 million but needs to save £12.7 million.

Criticisms of the STP to date have focused on the secrecy under which it was developed, the lack of detail in the document and the extent to which services will have to be cut.

The secrecy surrounding the STP has been criticised; prior to the October submission the STP had only been seen by a small group of health chiefs. It has been kept from MPs, councillors, NHS staff, GPs, unions and some hospital board members.

Speaking out about the STP, North Norfolk MP and former health minister Norman Lamb said he welcomed any extra money for mental health but said the whole STP was “unachievable” with the cash being made available and that “the detail is just not there.”

Although involved with the drawing up of the STP, Alex Stewart, chief executive of Healthwatch Norfolk, said their board did not endorse the STP document because they felt it did not contain enough detail about how patient care would be transformed.

“What concerns me still is that there is a lot of rhetoric but not a lot of action,” he said.