Provider collaboratives: Improving equitably – a new support offer

Julian Hartley profile picture

03 July 2023

Julian Hartley
Chief Executive


At NHS Providers, we are committed to supporting members to lead for improvement, and in their work to reduce inequalities in access, experience and outcomes. In partnership with the Q Community and the Health Foundation, and with support from NHS England, we have developed a new peer learning programme for provider collaboratives to combine these goals.

Provider collaboratives: Improving equitably will share learning on how collaboratives can use shared improvement approaches to tackle inequalities while driving progress on key operational priorities. NHS trusts are clear that provider collaboratives are one of the key vehicles for delivering the ambitions of system working, and with the recent and welcome launch of NHS Impact, there is a growing emphasis on continuous improvement as a route to tackle the current challenges facing the NHS, with an expectation this informs ways of working at every level.

Although there is still a lack of detail about what NHS Impact means in practice, evidence shows us that senior leadership is vital to the success of improvement, with role modelling the behaviours expected of others an important enabling factor in success. This high-level NHS approach also highlights a focus on health inequalities, as an enabler and driver of improvement-led delivery.

Tackling inequalities in outcomes, experience and access is threaded through current operational guidance, and supported by inclusion as one of the four objectives of integrated care systems. Once again, we know that whole-board engagement and leadership is critical if we are to translate these ambitions into reality, with this a key theme of the national Healthcare Inequalities Improvement Programme.

It is within this context that the new programme will provide peer learning events and resources to help board members to share the challenges and opportunities they face in creating a positive improvement culture in partnership. It will also help them to consider how to embed a focus on inequalities into existing and new quality improvement work.


What members have told us

There is already improvement work happening in providers, using existing skills and capabilities in the system to tackle current operational priorities. Many collaborative leaders agree there is an opportunity to add value with quality improvement and, as such, are making it a strategic focus for their collaborative, with a range of activity underway. However, we also know there is variation in the extent to which collaboratives have made progress so far, with some only beginning to embed their improvement work. We heard from many we spoke to that putting equity at the heart of their improvement approach is important to them, but there is less clarity on how to achieve this in practice.

Notably, board members, leaders of provider collaboratives and senior improvers have told us they are keen to harness the power of shared improvement approaches to create the optimism and energy needed to tackle inequalities in outcomes, experience and access, and rebuild towards higher quality of care for the benefit of local people.


How we plan to support provider collaboratives

The programme will provide much needed space to take a step back and reflect, with access to expertise and peer experts, alongside examples of evidence-based practice. It is designed to align with NHS Impact and is relevant to all board members with a role to play in enabling and championing large scale improvement, plus executive board-level leads for tackling health inequalities. The programme will consider what it means to turn commitment into meaningful, sustainable action.

It can be accessed in a number of engaging formats via our virtual knowledge hub:

  1. Board resources – Digestible insights on improving collaboratively and equitably, available to all members, to facilitate reflective conversations at board level.
  2. Peer learning events – Amplifying the learning from the existing evidence on collaborative improvement, and examples of using improvement approaches to tackle inequalities.
  3. In-depth workshops – based on member hot topics and led by and drawing on the extensive improvement expertise at Q Community and the Health Foundation.


Finally, we are committed to continuing our influencing work to help create a more enabling environment for sustainable, equity-focused, locally-led improvement. Following through on the promises of NHS Impact will require a change in mindset and behaviours in many organisations, including at a national level. We welcome NHS England's acknowledgment of this, and we will continue to work with them as they take forward their commitment to developing new ways of working. We are particularly mindful of the importance of trusts having the time and space to focus on improvement, and the need for NHS England to support and prioritise this alongside backlog and financial recovery.

Sign up to our first event on Harnessing the power of quality improvement to address inequalities.

About the author

Julian Hartley profile picture

Julian Hartley
Chief Executive

Sir Julian Hartley joined as chief executive in February 2023, having been chief executive of Leeds Teaching Hospitals since 2013, where he led a major programme of culture change and staff engagement to deliver improved quality, operational and financial performance.

Julian’s career in the NHS began as a general management trainee and he worked in a number of posts before progressing to a board director appointment at North Tees and Hartlepool NHS Trust.

In 2019 Julian was asked to be the executive lead for the interim NHS People Plan, having previously worked as managing director of NHS Improving Quality, and in 2022 he was awarded Knight Bachelor for services to healthcare in the Queen’s Birthday Honours.

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