Matt Carter argues that emerging forms of provider collaborative, led by a range of different health sector providers, can improve care for patients and demonstrate the benefits of moving away from the traditional NHS power base.
Primary, community, acute, and mental health care have always relied on each other, but current demographic changes and financial pressures have increased the necessity to collaborate.
Back in 2019, the NHS Long Term Plan cemented a focus on partnership, outlining a vision where different parts of health systems work together to deliver better care for local populations. Subsequently, the Health and Care Act 2022 has set out legislative reforms to achieve this, including mandating a shift away from competition towards a welcome emphasis on collaboration.
As a result, there is now an expectation that Provider Collaboratives – ‘partnership arrangements involving at least two trusts working at scale across multiple places’ – will play a critical role in Integrated Care Systems (ICSs).
However, when it comes to the prioritisation of health sectors within the guidance, there is a worryingly predictable bias towards the traditional NHS behemoths. NHS England’s 2021 ICS Design Framework says that acute and mental health trusts are expected to be part of one or more provider collaboratives, but community trusts, ambulance trusts, and non-NHS providers should participate if beneficial.
Despite the guidance emphasising Acute and Mental Health Trusts, there are now a variety of examples of successful Provider Collaboratives led by both Community Care and Primary Care providers. The benefits of these emerging, innovative models should not be overlooked, as they can add real value to the experience and quality of care for patients.
Mutual Ventures has been directly involved in the establishment of some of these partnerships, both within sectors and across sectors.
Our work on a community-to-community collaboration in the East of England has supported the establishment of a multi-provider partnership with a system-wide footprint. This partnership has been able to offer a wider range of job opportunities for staff, improving workforce retention, whilst increasing shared learning by encouraging the workforce to collaborate across organisational boundaries.
An enhanced ability for partners to compare and analyse specific areas of performance, and draw on the strengths of each provider, has improved patient outcomes. The maturity of the collaboration means the Integrated Care Board is now seeking to delegate key functions directly to it, blurring the lines between commissioner and provider.
Elsewhere, we have supported a Community NHS Trust and a Hospital NHS Foundation Trust in London to work across pathways, break down organisational barriers and integrate funding streams. This work has achieved a reduction in the number of ‘handovers’ and eliminated duplication by successfully creating a ’single team’. As clinical pathways have become more seamless, patient experience has improved during the transition from a hospital setting back into the community.
We are currently supporting a large GP Federation and Community NHS Foundation Trust in the North of England with an emphasis on addressing health inequalities for the local population by better partnership working. Through integrated ‘first contact’ teams in the community, this model is ensuring equity of access and more effective monitoring for Severe Mental Illness and Learning Disabilities cohorts, as well as building a compelling case for increased investment in the community.
In all their forms, Provider Collaboratives can be a powerful means of innovation in integrated care, regardless of which part of the NHS they are from. This shows it is time to move away from thinking solely about the ‘big players’ and defaulting to the traditional NHS power base.
The variety of cross-sector and within-sector forms of collaboration demonstrates the benefits of considering each partnership on its merits. Integrated Care Boards must acknowledge that each sector has a vital role to play in driving the collaboration agenda, in terms of leadership, culture and outcomes for patients.
To learn more about our work on provider collaboratives and how we could help you click here.
To speak about any of the issues raised in this article contact matt.carter@mutualventures.co.uk.
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