- Population: 1.3 million
- Places: Dudley, Sandwell, Walsall, Wolverhampton
- Trusts: The Dudley Group NHS Foundation Trust, The Royal Wolverhampton NHS Trust, Sandwell and West Birmingham NHS Trust, Walsall Healthcare NHS Trust
Since its inception in September 2020, The Black Country Provider Collaborative has successfully implemented a range of improvement programmes across its clinical networks, all of which have been made possible by the investment and engagement from its participating organisations. This case study is based on the conversations we have had with the collaborative’s core team members - Diane Wake (senior responsible officer), Dr Jonathan Odum (chief medical officer) and Sohaib Khalid (managing director). It will explore in depth the evolution of the collaborative drawing out practical examples of how the collaborative has enabled change through its clinical improvement programme, as well as the evolving nature of its governance arrangements and supporting infrastructure.
Background and context
The Black Country Provider Collaborative was formed in 2020 as providers across the country were challenged to adapt their ways of working to manage the pressures of the Covid-19 pandemic. Like many other parts of the country, the Black Country’s critical care capacity was significantly affected, and the four acute trusts within the system began working together more formally to ease some of these pressures through mutual aid.
Prior to 2019, relationships between providers across the Black Country system had been prone to tensions as a result of the focus on competition. The shift towards system working led to greater focus on improving relationships and more joint working, and the response to the Covid-19 pandemic accelerated the process, both practically and culturally.
Before the creation of the collaborative, siloed working was the norm and although some clinical networks existed, there was little else in terms of collaborative working. Alongside this, trust leaders from across the Black Country identified a number of key challenges facing the acute providers including:
- Deteriorating cancer health outcomes (particularly over the last five years).
- A growing elective backlog significantly impacted by the pandemic.
- Models of care driven by a previous competitive culture between trusts which needed improvement.
- Several services that could shortly be categorised as 'fragile' requiring urgent attention.
- A healthcare system facing financial challenges.