Trusts in systems: Working with partners for patients and communities

16 November 2022

A new report by NHS Providers shows how trusts are playing a key role in shaping, supporting and co-leading the development of system working.

Providers Deliver: Trusts in systems presents a series of case studies highlighting ways in which trusts are delivering on the priorities of integrated care systems (ICSs) and driving improvement through partnership working including provider collaboratives and place based arrangements.

The report shows how trusts are committing to closer collaboration and integration, recognising that 'system working' can help address immediate pressures and deliver longer term improvements to quality of care and service delivery.

Examples highlighted in the report reflect the impressive and varied approaches to collaboration being taken by acute, mental health, community and ambulance services. They include:

  1. work by Maidstone and Tunbridge Wells NHS Trust to ease their own and neighbouring trusts' backlogs
  2. an initiative involving North West Ambulance Service NHS Trust to reduce health inequalities and prevent ill-health
  3. the role of The Clatterbridge Cancer Centre NHS Foundation Trust and partners in supporting the urgent care needs of cancer patients
  4. collaborating across systems using virtual wards – Central London Community Healthcare NHS Trust
  5. Avon and Wiltshire Mental Health Partnership NHS Trust – supporting decision making across systems, improving efficiency and quality.


The report also includes a commentary by NHS England's chief operating officer, Sir David Sloman, who emphasises the 'absolutely central' role of NHS providers in support of increased collaboration through a range of different partnerships.

The interim chief executive of NHS Providers, Saffron Cordery, said:

"The NHS is facing formidable pressures, which are being felt across acute, mental health, community and ambulance services.

"But while acknowledging and addressing these challenges, it is important to identify, promote and celebrate success, and share learning and good practice.

"This report shows how trust leaders see system working as part of the solution to the difficulties they face.

"No single organisation can effectively address longstanding challenges like staff shortages, health and race inequalities and growing demand for services alone.

"That's why trusts are acting as 'engines of transformation', using their distinctive position to drive forward – and in many cases lead – the development of system working for the benefit of the communities they serve.

"Often these improvements are being driven by trusts working closely with one another and other partners in their systems.

"There is of course further to go in in embedding system working, and complex questions to iron out as systems develop and mature.

"But there is growing evidence that collaboration in the new landscape brings with it significant benefits and opportunities to deliver better care for patients and service users."