On Wednesday 16 October 2024, the four Commissioning Support Units (CSUs) welcomed over 80 delegates at the ‘NHS Trusts and Primary Care Collaboration Knowledge Sharing’ webinar.
In recent years all four CSUs have seen increased demand for support from Provider Trusts, Primary Care Networks and organisations involved in the delivery of social care, in addition to services provided to Integrated Care Boards and NHS England. This webinar was designed to provide insights on how, with the support of CSUs, health systems are already making the most of both vertical and horizontal collaborations.
Four case studies were delivered to demonstrate emerging best practice and real-world solutions that are already being delivered within provider collaboratives. These spanned a range of topics from the building blocks that form the critical foundations for successful collaboration, through to tools that empower collaborating organisations to drive operational effectiveness and improve services for patients.
Creating the conditions for system maturity
The first case study, delivered by NHS South, Central and West (SCW) CSU, focused on system convening support provided to One Gloucestershire Health and Wellbeing Partnership to create the conditions required for system maturity to deliver impact. Experts from the CSU’s Transformation team worked with senior leaders from across the partnership to deliver an Interim Integrated Care Strategy to meet statutory requirements set out by the Department of Health and Social Care. Leading a team from across the partnership, baseline assessments of existing strategies and data availability were completed before extensive engagement with stakeholders and the local population to feed into the interim strategy.
After the successful delivery of this initial work, the SCW team was then charged with empowering the partnership to develop relationships in ways that could further enhance delivery of their ambitions. This work utilised both the Tuckman model of team development and Cynefin Framework to hold a mirror up to the current partnership and develop a roadmap for development to ensure that all key stakeholders were best placed to achieve their collective goals.
Providing timely and easily interpreted intelligence
The second case study, provided by NHS Arden & GEM CSU, detailed learning and best practice from a project delivering analytics and intelligence expertise within cancer pathways across a collaborative network spanning seven acute providers in the East Midlands. When an unexpected fragility in the head and neck cancer services consultant workforce resulted in variation in patient outcomes, acute providers formed a ‘mutual aid’ operating model for the service - as well as establishing guiding principles for future unforeseen instances requiring a similar approach. The Arden & GEM Advanced Analytics Unit worked with network stakeholders to co-create a series of weekly dashboards that provided timely and easily interpreted intelligence to drive collaborative behaviours.
By working closely with those charged with making clinical resourcing decisions, as well as business intelligence representatives from each trust to explore data availability, this collaborative design approach provided flexibility and trust between all parties. The analytics empower the providers to make decisions on the most effective solution for issues – from loaning workforce to provide relief to redirecting patients to neighbouring services with greater capacity. The work has even resulted in a shift towards pan-regional workforce investment and is currently being extended for prostate and breast cancer services.
Establishing primary care collaborations
The third case study, delivered by NHS North of England CSU (NECS), focused on their support in developing and establishing the North East and North Cumbria Primary Care Collaborative (NENC PCC). As one of only four primary care collaborations across the entire English health economy, NENC PCC wanted to work across the four pillars of primary care to solve problems, influence decisions at a system level and enhance services for patients. NECS supported the collaborative to form objectives and priorities, following an established process for governance development that enabled the transition from a group of disparate organisations to a fully functioning collaborative.
Since this initial work, the Primary Care Collaborative has also called on a range of additional services from NECS to support their endeavours to deliver best in class primary care services. This has included data and analytics to enable population health management, support in rolling out the Pharmacy First national initiative and a range of activities to assist the delivery of an integrated workforce strategy.
Key factors for successful clinical redesign
The final case study was delivered by the Transformation Unit (TU), hosted by NHS Midlands and Lancashire CSU, and focused on clinical redesign and networks. With vast experience gained across multiple sectors within health and social care, the TU team detailed their tried and tested eight stage methodology for clinical redesign underpinned by robust patient and public engagement. The presentation summarised key factors for successful clinical redesign including ensuring new models improve care and are safe, the importance of taking account of new clinical guidance and consultation outcomes, and always applying good process improvement principles.
Drawing on their experience of working with provider collaboratives who were prioritising efficiency improvements in corporate functions, TU then moved on to describe their blueprint for effective clinical networks. With so many variations in clinical network approaches, the starting point is often determining the local definition. To develop the most appropriate approach, expertise is required to draw out the local drivers for the clinical network and to understand the level of resourcing. The blueprint approach provides five varying levels of network and helps collaborations to map where they currently are and where they aspire to be.
Alison Tonge, Director of Strategy, Innovation and Performance at Arden & GEM CSU then brought proceedings to a close by canvassing the audience for potential topics for future webinars. A specific interest was shown in digital tools enabling transformation for patients and workflow, integrated workforce transformation and integrated resource management in place/neighbourhood teams.
The full webinar is available by clicking on the link below.