Provider collaboratives: policy, models, benefits and pitfalls

Collaboratives, chains, partnerships and networks

On Monday 18th October, we had a comprehensive and high energy discussion about provider collaboratives – the policy evolution over the years, the different models/concepts, the potential benefits as well as the pitfalls to avoid.

Miranda Carter – Director of Provider Development at NHSE/I – started the evening with a potted history of various policy initiatives over the last 20 years all aimed at improving quality and financial performance.   While the broad thrust has changed from competition to collaboration, the opportunities to improve performance through increasing scale continue to be captured through a range of approaches – from lead provider models to chains/collaboratives through to more substantial mergers and acquisitions.

David Dalton – author of the definitive guide to hospital chains – Examining new options and opportunities for providers of NHS care – The Dalton Review (  shared his experience of leading a chain in Manchester as well as reviewing a range of models from across the UK and globally.    He emphasised the potential of groups/chains to improve quality of care, reduce inequalities in access/quality of care and ensure high calibre leadership across the country.    

Charles Knight – Chief Executive of Barts Hospital and Professor of Cardiology – talked about the journey Barts Health went on to become a high performing group model.   The early years saw a number of challenges – from poor financial performance to a disenchanted workforce – followed by a more considered approach to managing across sites resulting in significant improvements.   Charles also shared the impact of developing the Barts Cardiac Centre – bringing together cardiac services from across several sites in central/east London.   Despite numerous hurdles over many years, the consolidation of services has enabled a step change in outcomes – saving 1,000 lives a year.     

Lively discussion ensued raising issues of the ‘fit’, or not, with ICSs, where is primary care in all this?, the issue of place, how best to seed and develop innovation and tech, and as always the need for strong leadership, including clinical.

More information is in the attached slides.  

With thanks to DAC Beachcroft for hosting the event.