Matt Carter discusses how existing Provider Collaboratives can work with wider Place partners highlighting five key insights to embed partnership working and improve health outcomes.
With the establishment of Integrated Care Systems (ICSs) and the Health and Care Act in 2022, two key themes for the NHS have been: (1) the rather ambiguous focus on ‘Place’ and; (2) an emphasis on collaboration between providers.
I think we are now witnessing a merging of these two themes. As ICSs mature, provider collaboratives are starting to work in partnership with a wider range of organisations to address specific issues facing Places. But, building on the successes to date, there is more that providers can do to embed partnership.
Maturing Provider Collaboratives
Many Provider Collaboratives have now reached a stage of maturity where the hard work of implementation is done and partnership is becoming part of the day job. Transformation initiatives are moving to business as usual.
With shared visions and infrastructure established, providers can focus on joint organisational development, including development of branding and identity for the Collaboratives, alongside distribution of leadership. Collaboratives can shift to an outward-facing stance, seeking opportunities to work in partnership with organisations across the Places where they work, such as councils and the voluntary sector.
Benefits and risks
Working in partnership across a Place has many potential benefits. For example, a collaborative in South West London is working together with its Place partners to explore ways to improve workforce resilience and, through greater breadth of opportunity, improve both retention and attractiveness as employers and anchor institutions.
Collaboratives working with wider Place partners also enables genuinely innovative transformation of service pathways. For example, in South Yorkshire, a Community, Mental and Primary Care Alliance is working with Social Care on developing an integrated and co-located Urgent Response Service. As transitions between each healthcare setting and each provider becomes less fragmented and inefficient, patient outcomes and experience improve. With this, there are opportunities to work differently with collective assets, such as estate, IT infrastructure and patient data.
But there are also potential risks. The need for trust between partners means it may be necessary to overcome resistance from Place partners outside of existing collaboratives. During the establishment of Integrated Care Systems, council leaders went on record to say that they felt marginalised and stressed that their councils were essential for any ambition to focus on prevention and reducing health inequalities. Learning from this, it is essential that all Place partners define shared values and a vision from the outset.
However, as Place develop, pressure to alter Collaboratives' existing infrastructure and governance risks disruption and potential damage. Instead, Place objectives can often be achieved through partnership working based on relationships and shared goals, while ensuring that the benefits of existing Collaboratives are maintained.
How can we further embed partnership?
I am optimistic about the progress made so far towards genuine partnership at Place level – and the impact this will have for patient care, access, experience and outcomes. But what comes next in this journey and how can Places further embed partnership working?
With the risks and benefits in mind, provider collaboratives must find ways to maintain their evolving culture, momentum and focus on their own objectives, while remaining committed to supporting wider Place strategy.
For existing collaboratives and alliances, there are five insights that I think can support the opportunity to work with wider Place partners:
Build on previous successful in joint working with Place partners, for example, collaboration on vaccination or workforce programmes driven by a shared purpose during the pandemic
Actively seek to develop relationships and trust between Place leaders, for example by ensuring protected time together to learn more about each other and understand different organisational cultures
Focus on the function and purpose of Place, rather than becoming distracted by the infrastructure of collaboration. Start with the principle that ‘form should follow function’, and develop a shared vision.
Agree a small number of initiatives to start exploring out how all Place partners can collaborate most effectively, such as focusing on specific patient pathways or cohorts, enabling early identification of what works well
Identify early wins, for providers and patients, such as recruitment and retention initiatives, increasing user engagement and enabling the development of good news stories
Guided by these insights, Provider Collaboratives can develop practical, effective and sustainable collaboration across all areas of health and care provision. Together with their wider partners, including social care and the voluntary and community sector, Collaboratives can make an even bigger difference to improving outcomes for the people of each and every Place.
For more on our work in the NHS and to hear about how we could help your organisation, contact matt@mutualventures.co.uk.