Trust leaders have identified several key enablers that support provider collaboration at different stages of development.


Modelling collaborative leadership behaviours

The role of trust leadership teams is vital in embedding a culture of collaboration. Their contribution should be maximised within provider collaborative governance arrangements, while taking into account their limited capacity. Trust leaders need to bring their organisations and staff along with them by modelling new ways of working from the top.

The commitment of the organisations to work together have been liberating for clinicians. Getting out and meeting people to discuss clinical services, identify where the challenges are and to then look at ways to develop solutions has been overwhelmingly rewarding.

Dr Jonathan Odum    Chief medical officer, Royal Wolverhampton NHS Trust

Aligning around shared ambitions

Investing time at the outset to develop a shared purpose is essential. Trust leaders tell us that engaging with clinicians and service users to co-produce the collaborative’s priorities is valuable. Working closely with wider partners such as local authorities is also key to success. These discussions will ideally be anchored in the health needs, strengths and aspirations of local communities, and will be convened in a way that empowers participants with strategic influence.

Agreeing a purpose early on and our shared ambitions is probably one of the most important things we did.

Siobhan Melia    Interim chief executive, South East Coast Ambulance Service NHS Foundation Trust (on secondment from her role as chief executive, Sussex Community NHS Foundation Trust)

Building trust

It is essential to build and retain trust at board level across the organisations involved in the provider collaborative. Understanding the history of partner organisations and their previous relationships can help to unlock more collaborative ways of working. Being open about organisational ‘red lines’ and having ‘open book’ finances are key. Service users and staff need to be assured of trust boards’ commitment and intentions. Bringing people together at conferences and meetings helps develop buy-in and strengthen a culture of collaboration and co-production.

It feels like there is an opportunity for provider collaboratives to do more and we at WYAAT are keen to take on more programmes of work… I think that a lot of the energy and commitment comes from the sense that we are entering into this in a voluntary way and we all want it to work.

Julian Hartley    Chief executive, Leeds Teaching Hospitals NHS Trust

Clinical leadership

Clinical leadership should be at the heart of provider collaboration, with improving services and outcomes for local populations as the driving force behind the collaborative’s programmes. Early engagement is vital to securing buy-in from clinicians who will lead much of the service improvement and redesign work.

Clinical summits have played a big part in getting people to buy into working differently, as has working through lots of the old challenges through mutual aid. Working collaboratively gets you much further, much faster, and it’s much more pleasant than competing with each other.

Diane Wake    Chief executive, The Dudley Group NHS Foundation Trust

Ensuring form follows function

Progress is enabled by remaining focused on the purpose and aims of collaboration. Discussions about the form or model of the collaborative should flow from a clear articulation of strategic direction. Trust leaders say a lean management approach can evolve iteratively as the potential of the collaborative develops.

The experience of developing the provider collaborative has felt like being on a water slide, going at varying speeds, fast and smooth, bumpy and scary...but people are glad we are where we are now.

Alan Burns    Chair, Northampton General Hospital NHS Trust and Kettering General Hospital NHS Foundation Trust

Building capacity

Committing and mobilising sufficient capacity to develop and deliver the collaborative’s work programmes is critical, including the roles of programme directors and programme management offices. Many collaborative arrangements rely on the input of senior executives and board members; there needs to be sufficient support, delivery, and organisational development capacity in place to move programmes forward.

It’s really helped that we started small with high-risk and high-cost patients and built out from there. We’re now keen to engage with other collaboratives to avoid the risk of developing sector siloes.

Melanie Walker    Chief executive, Devon Partnership NHS Trust

Supporting staff through change

Successfully embedding provider collaboration involves paying attention to the human and emotional factors that can accompany change, including fear and resistance. If collaboration may lead to exploring major service changes, such as consolidation of services across sites, leaders need to give careful thought to how communities and staff will be involved in co-designing and implementing those changes.

Getting clinicians and service users together to look at the outcome data to see where there is variability across the patch or where outcomes are below the national average is a great way to galvanise support around improving a service collaboratively.

Melanie Walker    Chief executive, Devon Partnership NHS Trust