Cheshire and Merseyside Acute and Specialist Trusts Provider Collaborative (CMAST) have a provider leadership board approach with a committee in common (CiC) to support decision making.
CMAST also operates and facilitates a federated model of collaborations, connections, and networks across their system through its professional groups. These provide a vehicle through which work can be progressed, initiated, or delegated (from the board) and encourage and support collaboration across professional disciplines.
Where decision making is required which is beyond the responsibility of a professional group or the combined authority of the CMAST chief executives, CMAST has the ability to initiate a committees in common process to support combined and aligned system decision making across each statutory trust or a subset of these.
Depending upon the views and inputs of CMAST trusts and their boards, the decision-making framework allows for these decisions to be taken by either chief executives or chief executives with trust chairs.
Their work, priorities, values, and behaviours are set out within a joint working agreement and are refined and documented through an agreed annual workplan which identifies key milestones and provides a platform to begin to describe anticipated decision-making points associated with their programmes of work.
Organisation development
At an early stage in the development of CMAST, the chief executives took part in some organisation development (OD) work led by external legal and NHS leadership experts which helped them to test and validate their shared vision, values and priorities. The trust chairs also joined some of these discussions which supported ownership, the process of working through what decision making in CMAST might look like and the appropriate level of connection to trust boards.
There has also been some engagement with all the non-executive directors (NEDs) of the providers in CMAST, which helped familiarise the NEDs with the imperative of system working, integrated care system (ICS) establishment and the role of collaboratives and their work programmes within this space before they were faced with it in trust board meetings.