NHS collaborate – Top tips for Trusts

Between 2017 and 2022 there was an NHS Collaborate website, which served as a promotional site about the benefits of collaboration and areas of opportunity, but this has since closed down with the launch of FutureNHS. 

In their words: “Collaborate is [was] a mutually supportive community of leaders across primary care. Our mission is to ensure no leader in primary care feels alone or isolated. Collaborate is not aligned to any one organisation or profession, but is a dynamic and energised community of individual and emerging leaders with an interest in primary care. We support people who want to make a difference, people who want to take risks, and people who want to be brave, whether they have the word ‘leader’ on their badge or not.” 

The NHS Long Term Plan mandates collaboration now, rather than the previous NHS approach encouraging it, which is perhaps why the website closed down, but it’s proof that the ambition and appetite was there in the healthcare sector beforehand – it just needed a more concerted effort from the NHS to get the ball rolling.

NHS England’s ‘Building Collaborative Teams’ workshop guide states that collaboration can improve communication and working relationships, reduce duplicated effort, save staff members time, and ultimately create a better patient experience. 

Collaboration is in aid of achieving joined-up care – something National Voices touches on below:

A lot of the subject matter we keep coming back to – regarding technology or services – revolves around joined-up care and how it can improve the patient experience. NHS England is aware of this too. Their Patient Experience Book states: “Patients and users tell us that they value their experience of care as much as clinical effectiveness and safety.” 

That is a huge statement, and a big area where the NHS as a whole needs to catch up on, because a large part of why the patient experience is difficult isn’t down to poor bedside manner, or a lack of interpersonal skills from healthcare professionals (maybe the odd receptionist here and there), but actually because of poor collaboration. 

Patients want a smooth, hassle-free experience. They’re unwell – they don’t want to suffer longer than they must. They want referrals to be prompt, clinicians to be polite and knowledgeable, and treatment to be effective. Nothing outrageous, but something yet to be consistently achieved.

It's not just for patient benefit either though. Effective collaboration improves the patient experience, and indeed patient engagement with their own wellbeing, as a by-product of improving the operational efficiency of healthcare services. If things work better, problems such as delays, miscommunication, staff absence… these problems all decline as the pressures that cause them are alleviated. 

The NHS Constitution’s first value is to work together for the sake of patients. Collaboration should be exactly that, and the NHS’ big challenge isn’t to get the software solutions in place to facilitate these partnerships but to destroy the outdated mentality of competitive focus. Collaboration needs to now replace competition; cooperation can achieve more financially, and in productivity terms but that isn’t apparent to many organisations. 

This is because of the need for self-preservation. When times get hard, many people will feel the need to put themselves first. It’s the same for some organisations too. In some cases, funding is tight, so the Trust comes first and concerns about other areas of the NHS are secondary. However, this thinking ignores the group strength of being more valuable than its core components. There are benefits in better staffing and reducing agency spend, sharing the costs of back offices, better bidding or bulk buying of supplies… 

This is where the Integrated Care System (ICS) comes in. It has the power to override the ethos of putting yourselves first and will make more optimal decisions for the greater good. The NHS Long Term Plan already refers to Mutual Aid and that’s what has to happen; leadership cooperating and sharing intelligence and wisdom to ensure organisations collaborate and not just succeed but thrive. 

There is a genuine risk of the NHS succumbing to outside pressures to privatise through its own shortcomings in service and performance. Collaboration is a way to turn things around, and the NHS is perfectly suited to quickly adapt to these new operational processes and to be one big joined-up care network.

There are some examples of collaboration in action within NHS England trusts.

Example 1 – Northampton Healthcare NHS Foundation Trust 

Collaboration within Northampton Healthcare NHS Foundation Trust (NHNFT) has meant that Northampton General Hospital’s A&E department has seen an average reduction in attendance by regular attendees of 50%. 

Their case study targeted patients who specifically attended the A&E department very regularly due to specific mental or physical needs that weren’t being engaged with enough by care services elsewhere within the Trust or beyond it. 

Speaking to the NHNFT website, consultant Mike Pearce said: “By developing an approach which looks at each patient’s individual needs, and how they can be best supported, we have worked together with our partners and helped prevent some of these frequent attendances. This is better for patients, has meant services have worked together very effectively, and it has helped reduced pressure on our very busy emergency department.” 

Example 2 – Leeds Teaching Hospitals NHS Trust  

Leeds Teaching Hospitals (LTHNT) works with the University of Leeds and Leeds City Council for training, community care engagement, and education/strategy for local healthcare.  

Beyond this though there’s a specific West Yorkshire Association of Acute Trusts (WYAAT); a collaborative body of six NHS Trusts that strives to encourage cooperation and provide the greatest capacity service to the millions in the West Yorkshire region. 

LTHNT is also a founding member of Leeds Academic Health Partnership. This is a collaborative between the NHS organisations in the city, all three city universities, and the city council. This organisation is more strategy-led; seeking to address the population’s challenges to health and wellbeing, whether medical or socio-economic.

Example 3 – Black Country Provider Collaborative 

Four acute care providers – Sandwell and West Birmingham Hospitals NHS Trust, The Dudley Group NHS Foundation Trust, The Royal Wolverhampton NHS Trust and Walsall Healthcare NHS Trust – formed a Black Country collaborative late in 2020 to adapt to the working demands of the Covid pandemic and to “promote better partnership working”. 

This is a different type of example, with the link taking you to a handbook for collaboration from the NHS, but hopefully it’s a helpful insight into how the NHS is reaching out top-down to Trusts to give them the guidance required to establish and maintain good quality relationships with other Trusts.

Example 4 – Portsmouth & South East Hampshire Clinical Commissioning Groups 

Our final example goes back to 2015, before the launch of Integrated Care Systems and specifically Hampshire and Isle of Wight Integrated Care System. 

This PDF document was the official working brief for NHS Portsmouth and NHS Fareham and Gosport, which laid out the powers and duties of the CCGs and the collaborative efforts that should follow. 

“The groups focus is on the development and delivery of the shared commissioning work programme, ensuring that this fits with individual CCG strategies and integrated commissioning arrangements. It is an advisory group with individual formal decisions taken in the respective CCGs via their own governance arrangements.” 

The document specifically sets out ‘Collaborative Arrangements for Work Programmes’ and provider relationships with collaborative commissioning, and highlights the earlier efforts made to encourage collaboration and joined-up thinking towards delivering healthcare – before the NHS made it a mandatory responsibility.

NHS England and NHS Improvement operate FutureNHS. This NHS future collaboration platform is available to anyone in health and care work. Its purpose is empowerment through collaboration, communication and education. 

The FutureNHS platform was launched during the pandemic and partly runs of Microsoft Teams so that people can call and message securely, but this has expanded to have more of a library purpose to support interested parties so that they could better articulate what they need or want to achieve. 

This means whatever your role, there are resources available to engage with and learn from, as well as opportunities to get in touch with subject matter experts or talk with people in similar situations to yours – or your organisation’s. 

For added security though, all users have to be logged in and identifiable, and workspace managers can see an audit log for user activity to ensure that people are behaving in an appropriate and respectful manner; whether in case of abuse or breaching privacy.

There’s a lot of guidance on the top tips for NHS Trust collaboration, courtesy of NHS Professionals and NHS England, but we’ve distilled out eight key things to work towards in establishing collaboratives. 

1. Common Purpose: A singular focus can help individuals or organisations to work towards a goal, rather than feeling overwhelmed or confused by larger strategy.
2. Patience: Collaboration takes time. Be patient. You need to establish strategy and make sure the goals are fair for all parties, not just one.
3. Relationships: You can’t magically establish relationships, and the subsequent trust and understanding. You need to work at it, because there will need to be compromise. People will oppose it, and it’s important to overcome their opposition for the greater good.
4. One Goal, Multiple Approaches: Compromise doesn’t mean unification on everything. You can have different approaches to the same goal, without it being a point of controversy or contention. It might even help with the best assessment of a situation – a form of A/B testing to decide which approach is best.
5. Technology: Software can lead the way. Sharing data and other information is vital to fostering any connections, and good solutions can support that.
6. Leadership: Coordination from senior support is vital. Management need to establish/approve sessions, or set aside time, to allow for collaboration to happen. If you show collaboration the respect it deserves, the investment will see returns.
7. Patient Experience: By assessing patient experience/patient engagement you can highlight the gaps in your organisation’s operations. From there you can coordinate with others in your trust, or other trusts, to see how best to address these gaps. Shared knowledge can create shared solutions, rather than expecting isolated discoveries.
8. Preparation: Similar to the patient experience, have a way to measure progress or success from the beginning of the collaboration process, so that performance can be tracked and agile amendments can be made.

This concludes our guide to collaboration in NHS trusts. We hope it offered insight and gave you some ideas on how to cultivate engagement around cooperation, but for more information you can read our primer on Collaborative Working in the NHS or you can read up on our Rio software solutions and how they can assist with integration and collaboration.