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The spatial politics of place and health policy: Exploring Sustainability and Transformation Plans in the English NHS

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  • Hammond, Jonathan
  • Lorne, Colin
  • Coleman, Anna
  • Allen, Pauline
  • Mays, Nicholas
  • Dam, Rinita
  • Mason, Thomas
  • Checkland, Kath

Abstract

This paper explores how ‘place’ is conceptualised and mobilized in health policy and considers the implications of this. Using the on-going spatial reorganizing of the English NHS as an exemplar, we draw upon relational geographies of place for illumination. We focus on the introduction of ‘Sustainability and Transformation Plans’ (STPs): positioned to support improvements in care and relieve financial pressures within the health and social care system. STP implementation requires collaboration between organizations within 44 bounded territories that must reach ‘local’ consensus about service redesign under conditions of unprecedented financial constraint. Emphasising the continued influence of previous reorganizations, we argue that such spatialized practices elude neat containment within coherent territorial geographies. Rather than a technical process financially and spatially ‘fixing’ health and care systems, STPs exemplify post-politics—closing down the political dimensions of policy-making by associating ‘place’ with ‘local’ empowerment to undertake highly resource-constrained management of health systems, distancing responsibility from national political processes. Relational understandings of place thus provide value in understanding health policies and systems, and help to identify where and how STPs might experience difficulties.

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  • Hammond, Jonathan & Lorne, Colin & Coleman, Anna & Allen, Pauline & Mays, Nicholas & Dam, Rinita & Mason, Thomas & Checkland, Kath, 2017. "The spatial politics of place and health policy: Exploring Sustainability and Transformation Plans in the English NHS," Social Science & Medicine, Elsevier, vol. 190(C), pages 217-226.
    • Handle: RePEc:eee:socmed:v:190:y:2017:i:c:p:217-226
    DOI: 10.1016/j.socscimed.2017.08.007
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    Cited by:

    1. Sanderson, Marie & Allen, Pauline & Moran, Valerie & McDermott, Imelda & Osipovic, Dorota, 2020. "Agreeing the allocation of scarce resources in the English NHS: Ostrom, common pool resources and the role of the state," Social Science & Medicine, Elsevier, vol. 250(C).
    2. Kendrick, Hannah & Mackenzie, Ewan, 2023. "Austerity and the shaping of the ‘waste watching’ health professional: A governmentality perspective on integrated care policy," LSE Research Online Documents on Economics 120265, London School of Economics and Political Science, LSE Library.

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