Primary care collaboratives can power a local approach to care

Professor Aruna Garcea says there has been continued demand for support and advice on forming collaboratives which can increase primary care’s involvement in system decision-making 

Primary care is the front door to the NHS for the majority of patients and like the rest of the health and care system it is dealing with record demand, workforce gaps and financial pressures. With practices providing nearly six million more appointments in March than the same month before the pandemic, it is vital to find ways to improve how the sector manages these pressures.

One way of doing this is through primary care providers within local health systems coming together to form collaboratives. These cover a variety of partnerships between providers of primary care services at any scale and of any size, but we are specifically referring to those that come together to operate at a system level, under a unified collaborative, often named ‘primary care boards’.

We published a report last year providing an in-depth look at what they are and why they are needed. These partnerships can support integrated care systems’ (ICSs) strategic objectives and create a much-needed voice for primary care at system level.

Primary care collaborations take different forms across the country, with some systems providing funding and support. This welcome recognition has increased primary care’s involvement in system decision-making. This has in turn enabled unified and accountable primary care representation, improved primary care resilience, involvement in the redesign of services and pathways and new opportunities to cooperate with partners.

But these collaborations do not operate everywhere and without a commitment to develop, resource and maintain them there is a risk they become ineffective or never get off the ground.

Since our report there has been continued demand for support and advice on forming and operating provider collaboratives. While we acknowledge the importance of primary care forums, we know that provider collaboratives can go much further than that.

This is why we are conducting research into the the types of collaboratives that exist, looking at the difference they make, future opportunities and their potential as a formal part of the provider landscape within systems. We expect our report to be published in July.

This research is expected to help us understand how national guidance could promote and encourage the formation of collaboratives as well as how to define the role of collaboratives in the system as a key component in the planning, delivery, and transformation of services.

We know that in the long-term, they could power a more locally-driven approach to primary care which can be achieved through streamlined national contracts and increase local incentive schemes. Resources will be looked at closely in our work to understand how we can work with NHS England and the Department of Health and Social Care to best support collaboratives.

Primary care provider collaboratives can create a genuine golden thread of accountability from local practices and providers to systems. If resourced properly they can also support practices and primary care networks to create a communication channel to share insight and build improved leadership opportunities for the primary care workforce. This in turn results in better, more tailored care depending on community needs.

Given that primary care is the front door to the NHS, these collaboratives can pave the way to truly locally led decision-making. 

Professor Aruna Garcea is clinical director for Leicester City and Universities PCN and chair of the NHS Confederation’s PCN advisory group. Read more of her articles here.