This paper focusses on the role of providers of acute, specialist and mental health services acting through “provider collaboratives” in the emerging ICS landscape. Providers face a particular challenge because they will be expected to join up services both within places (for example, by collaborating with primary, community and social care providers through place-based partnerships) and across places on an ICS or wider footprint (for example by providing mutual aid for services at scale through formal collaborative arrangements in provider collaboratives). Our aim is to give providers clarity on the options available to them to meet the provider collaborative challenge.
Integrating services continues to be at the heart of NHS policy. From April 2021, all organisations within the NHS will be required to work together as Integrated Care Systems (ICSs). At present, collaboration is on a voluntary basis and ICSs themselves have no statutory status. However, the government’s legislative proposals set out in the white paper Integration and Innovation: working to improve health and social care for all (February 2021) intends that ICSs become statutory organisations in 2022 through changes to primary legislation.
If approved by Parliament, the new legislation will make participation in an ICS mandatory for all NHS organisations and strengthen the range of levers available for encouraging collaboration within a system. Existing ICS arrangements will form a strong basis for these changes, but each system will need to understand the implications of these changes (both collectively and individually) and consider how their current arrangements need to change or evolve. In particular, the role of providers in these systems will need to be informed by the earlier guidance issued by NHS England and Improvement Next steps to building strong and effective integrated care systems across England (November 2020) which makes recommendations regarding the role of provider collaboratives.
All providers are expected to be part of one or more ‘provider collaboratives’, depending on the systems they operate within. As a minimum, provider collaboratives will be responsible for:
- Delivering relevant programmes on behalf of all partners in the system
- Agreeing proposals developed by clinical and operational networks, and implementing resulting changes (such as implementing standard operating procedures to support agreed practice; designating services to ensure their sustainability; or wider service reconfiguration)
- Challenging and holding each other to account through agreed systems, processes and ways of working, e.g. an open-book approach to finances/planning
- Enacting mutual aid arrangements to enhance resilience, for example by collectively managing waiting lists across the system
Provider collaboratives can deliver tangible benefits, and many of these have been highlighted during the COVID-19 pandemic when Trusts and other partners have been working more closely together than ever before. It will be important to build on this momentum to tackle the health and care challenges facing the country when the pandemic starts to subside, in particular the elective backlog.
We believe that all systems will need to consider how to respond to the developments discussed in this paper. Many systems have already formed a provider collaborative of some sort, but every provider will need to consider whether these arrangements are really delivering on their ambitions/goals. Much like the ICS development framework, we anticipate providers being asked to evidence where their collaborative sits on a spectrum from ‘emerging’ to ‘thriving’, and to demonstrate how and when progression will take place. We are unique in having the experience to support you in this.
Many systems will need help to navigate the myriad of available options, and the right independent support can be particularly helpful in navigating the sensitive politics that often surround the development of provider collaboratives.
We understand that the skills required to support these projects are many and varied, and that any single service organisation is unlikely to be able to fulfil this brief. The combination of Teneo, Hill Dickinson and Dalton Consulting bring unrivalled expertise to the table to help organisations and systems explore and deliver new ways of working.
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