Hospital groups or chains could improve the sustainability of the NHS provider sector, says paper issued by Credo Consulting

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The provider sector faces significant challenges in form of rising demand, severe workforce shortages and an increasingly constrained funding environment. This paper highlights the opportunity for providers to work together under more formal arrangements to create system-wide solutions to these challenges.

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The paper suggests that there are significant advantages of organisations working together at scale.

The paper, "NHS Group Models: Working together for a more sustainable NHS", has been produced by Credo Business Consulting and draws on its experience of working with three of the four Trusts accredited to pursue Group models; the Royal Free London NHS FT, Salford Royal NHS FT and Guy’s & St. Thomas’ NHS FT.

It says that the current system, where providers are often compelled to compete for resources, talent and patients, has created wide-scale variation between organisations, misaligned incentives and duplication, which act to further exacerbate the health inequalities seen across England.

The paper suggests that there are significant advantages of organisations working together at scale. For example, by working as a Group providers can:

  • Provide a platform for identifying and addressing unwarranted clinical variation. Scale enables this by providing the necessary expertise, evidence base, and analytics, which smaller organisations would struggle to replicate;
  • Leverage highly capable leaders with proven track records across an enlarged base, while nurturing and developing ‘up and coming’ leaders through better support mechanisms and improved career paths;
  • Align incentives and remove organisational barriers, thereby enabling leaders to make better decisions at pace that benefit both patients and reduce total system cost;
  • Enable significant improvements in quality and cost through economies of scale, joint procurement, and investment in standardised systems and processes;
  • Support the pooling and sharing of resources (both people and capital) across multiple organisations, resulting in better expertise, higher utilisation, and greater ability to invest; and
  • Enable the workforce to be deployed more flexibly across a wider footprint, resulting in better use of resources, improved responsiveness and an enhanced staff experience.

The report also highlights that there is a spectrum of organisational models for providers to consider, and stresses the need for organisations to design a model that addresses their individual opportunities and challenges and works within their local environment.

Martin Smith, Assessment Director at NHS Improvement has welcomed the report, saying that

“This report highlights both the opportunities and the challenges facing providers who are testing and trialing new models of care, such as groups or chains. It also highlights the potential benefits of greater provider collaboration, in terms of improving quality of patient care, reducing unhelpful variation and making better use of resources. We are working hard with all providers to support new and innovative models of care, including our work with NHS England to support STPs. These findings will help providers to make sure plans are robust and deliver the best outcomes for patients.”

Edward Matthews, Partner at Credo Business Consulting said,

“Without major breakthroughs in how to deliver ‘more for less’, it is difficult to envisage how the current system will cope with the demographic, workforce and funding challenges it is likely to face in the coming years. We believe that the new models of care being developed by the numerous Vanguard sites across the country are critical to achieving this. We hope that providers who are considering new forms of collaboration find this paper a useful and practical source of information.”

The full report can be downloaded here (PDF, 3.8mb, active from 13/06/2017).

The report was published on 13th June 2017 in conjunction with Kaleidoscope Health & Care’s “Collaboration: Know how?” event series.

Lucy Thorp, Senior Manager at Credo Business Consulting, can be seen discussing the findings of the paper at the “Collaboration: Know how?” webinar hosted on 7th June 2017.

Notes to editors:

  • For further information contact Lucy Thorp on 02032068800 or at lucy.thorp(at)credoconsulting(dot)com
  • "NHS Group Models: working together for a more sustainable NHS" has been written by Credo Business Consulting ( Credo is a strategy consultancy, with significant experience across the Health and Social Care services sector, where it provides a mix of strategic, organisational design and performance improvement support to both public sector and private providers

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Lucy Thorp
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