Initiatives to help improve people’s health and wellbeing will need a wide range of partners to work together within integrated care systems (ICSs) and place-based partnerships. Trusts are key partners in this work, alongside local government, social care, primary care and the voluntary and community sector. Other sectors that impact the wider determinants of health also have a fundamental role to play, including housing, education and business.

This briefing aims to support the development of successful place-based partnerships by articulating the essential contributions of trusts – as one of several key partners – and exploring how trusts’ role at place might evolve over time. It sets out how trusts are involved in strategic place-based planning in partnership with others and in delivering joined up care.

Drawing on five case studies, we set out in practical terms how places around the country are developing their partnership arrangements, and the role trusts are playing in them. These places were chosen to demonstrate the variation in how partnerships are developing based on their size, context and population needs. We chose places with a range of experiences and approaches, and interviewed some of the trust leaders, across acute, mental health, community and ambulance sectors, working in those places. 

By exploring a range of leadership and decision-making arrangements, we hope to demonstrate that there is no 'one size fits all' model for working at place. There are many ways that trusts are working with partners to improve care for local communities, and we suggest a set of recommendations for national policy makers to maintain this flexibility as we move beyond the Health and Care Act 2022 into implementation.