Case study: Stronger Together with Camden Health Evolution and Haverstock Healthcare
Updated: Apr 15
Client: Camden Health Evolution (CHE) and Haverstock Healthcare (HH)
Date: December 2019 – March 2019
Challenges faced by the client: Camden Health Evolution and Haverstock Health are two GP federations that between them represent practices across Camden. Historically the two organisations have operated separately, but as the integrated care agenda moves forward at pace, they have been proactively pursuing opportunities to work together.
Both federations agreed that the creation of the Integrated Care System required a unified voice of primary care and more consistency in design and delivery of services at borough level. In addition to this, the recently developed Primary Care Networks (PCN) would benefit from consistent technical and development support provided at scale across the borough.
To support the local strategy to deliver integrated care and place-based plans, both federations jointly commissioned independent external support to develop options for strengthening and unifying the voice and governance of primary care at scale in Camden.
Support offered: MV delivered an independent options appraisal to explore potential delivery models which would help to achieve a unified voice and governance of primary care at scale.
The project required guiding stakeholders through difficult, technically complex and highly emotive change, therefore our project approach was collaborative and the project team worked in close partnership with both federations. The options appraisal process was underpinned by extensive stakeholder engagement, including a range of interviews with PCN Clinical Directors, Chairs of the Local Medical Committee and representatives of individual GP Practices.
We started with ensuring there is a genuine agreement on the function and shared goals for the future federation, and understanding of any potential red lines that would not be acceptable to the stakeholders. We investigated the potential governance and legal arrangements (including the relationship with and between the existing two federations) as well as looked into the most appropriate operating model (i.e. the relationship between the federations, PCNs and individual practices).
Outcome achieved: We identified and evaluated a number of options, including joint working underpinned by a contractual arrangement, merger or setting up a new organisation.
The options appraisal showed that there is no silver bullet to strengthening and unifying the voice and governance of primary care at scale in Camden. There are trade-offs between the potential options that needed to be carefully considered.
Representatives of PCNs across Camden recommended a merger as the most pragmatic and preferred solution going forward. A significant programme of that needs to be delivered for the merger to be successful was outlined, including:
agreeing vision, values and objectives that all Camden practices can sign up to;
designing governance structures that ensure transparency and equity for all Camden practices;
designing a new brand that reflects the jointly agreed purpose, vision and values could allow to build trust and cut through legacy issues.