- Collaboration needs to promote inclusivity and ensure all voices are heard and valued. There can be challenges in achieving 'collaborative leadership' and there is an art and skill to keeping all relationships positive as some provider collaborative leaders often wear multiple hats i.e. 'commissioner', 'collaborator' and 'provider' when lead provider collaboratives report back to NHS England commissioners.
- Communication from provider collaboratives needs to be continually adaptive and flexible as well as open and transparent in order to form trusting relationships to share ideas, knowledge and feedback.
- It can be a challenge to bring together a large number of providers to agree a shared vision and goals. Relating all work back to achieving service user led outcomes helps with this bond.
- Creating a culture of learning and continuous improvement is vital. The risk taking and the collaboration to jointly invest and move in the same direction can be more challenging for larger transformation and investment areas than it is to set up operational procedures or practices. At IMPACT, the East Midlands Provider Collaborative (IMPACT), they work hard to generate transparency and shared devolved power to make collective decisions as a collaborative in their governance structures.
- Time constraints and competing priorities can be a challenge – providers can become overwhelmed with competing tasks, deadlines and multiple commissioners asking for different priorities or to feed into multiple systems. This can be even more of a challenge for providers who are part of multiple collaboratives across the country and this can lead to a generic single approach that they have to apply. Time constraints mean they cannot be bespoke to each collaborative's strategic plans and intentions.
- Traditional organisational hierarchical structures can slow down communications – e.g. embedding new practices across all wards/board to ward decisions being disseminated down. IMPACT have a new communications lead to support them with this.