Will provider collaboratives be the new centre of power in the NHS?
Updated: May 4
John Copps argues that provider collaboratives will reshape the NHS landscape for years to come, which means the stakes are high for everybody.
The shift towards integrated care in the NHS has profound implications for the relationships between NHS providers, including the rise of new ‘provider collaboratives’.
As NHS England puts it, provider collaboratives are ‘partnership arrangements involving at least two trusts working at scale across multiple places’. Acute and mental health trusts have been told that they must be part of at least one provider collaborative, whilst other providers that they should be.
The ‘at scale’ part of NHS England’s definition is significant, as collaboratives are set to cover large areas, reflecting the territory of their constituent organisations. Many of them will straddle multiple places and systems.
Provider collaboratives will undoubtedly became key players in the new NHS landscape – perhaps the key players. So just how influential will they be?
A new power base
If power and influence is vested where the budget lies then, as the sum of their parts, provider collaboratives will hold a vast proportion of NHS spend.
Forthcoming changes to NHS governance will further amplify their influence. As part of the new governance structure of systems and places, the members of provider collaboratives will be able to form a powerful bloc and play a central role in establishing local priorities. System-level commissioning and the phasing out of CCGs leaves a gap, which means provider collaboratives will wield greater control over local resources.
Added to this, a new provider selection regime focused on encouraging collaboration is likely to favour the preservation of existing arrangements, unless there is a strong reason for change.
Provider collaboratives are getting up-and-running across the country, although everyone is at a different stage of development. What is clear is that there are many different flavours of partnership involving all types of provider: community, mental health, acute and primary care.
An early mover was the Mid and South Essex Community Collaborative, bringing together North East London NHS Foundation Trust, Provide CIC, and Essex Partnership University NHS Foundation Trust to improve pathways of care, and share resources and insight. Elsewhere, South Yorkshire and Bassetlaw is in the process of implementing an alliance between South West Yorkshire Partnership NHS Foundation Trust and Barnsley Healthcare Federation, focusing on the benefits of increased collaboration between community services and primary care.
The lessons so far are that putting together provider collaboratives is not always straightforward, particularly where trusts are more used to competing with each other. The benefits of partnership must be weighed alongside the interests and influence of individual organisations, financial implications, and how they will impact the experience of patients.
The potential power held by collaboratives makes it critical that NHS providers get on the front foot, if they haven’t already.
NHS organisations have always worked together but, with momentum behind them, the new breed of provider collaboratives look set to shape the care patients receive for years to come. How this plays out will vary, dependent on local circumstances and relationships. The stakes are high for NHS organisations and for patients,.
Watch a recording of our webinar, in partnership with Bevan Brittan LLP, on How to form effective provider collaboratives in a reformed NHS here.