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Assessing the development of primary care provider collaboratives and what they need to thrive.

Key points

• Primary care provider collaboratives are largely new, with many having formed over the last two years. In many areas, they are built on the success of GP federations, with others operating under relatively informal arrangements. There is significant variation in the formation of primary care provider collaboratives, with differing governance arrangements, variation in their geographical coverage and differences in their overarching purpose. 
• For those more ‘mature’ collaboratives, some welcomed the opportunity to go further. For example, looking at the spectrum of 24/7 urgent care, supporting waiting list recovery and being the anchor for neighbourhood health centres. 
• Primary care provider collaboratives are undergoing a significant evolution and development in response to the drive for integrated care and the need to ensure the contribution and role of primary care is effectively included. Many have already demonstrated benefits of providing a coordinated and large-scale response from primary care, as well as the ability to contribute to work across the system and in some cases, to deliver services. 
• There is an opportunity for primary care provider collaboratives to support the shift to care closer to home, driving transformation and working with partners to deliver that change. 
• Relationships are a critical factor in primary care provider collaboratives, both within the collaborative, and with the wider system or at place. Most primary care provider collaboratives focus on general practice, but some include or plan to include pharmacy, optometry, audiology and dentistry. 
• While some collaboratives are directly delivering services, most are currently providing a collective voice for primary care/general practice within their system or at place, ensuring that primary care is represented in discussions, has input into pathway design and is consulted on issues that affect primary care. 
• The relative immaturity of primary care provider collaboratives provides significant scope for their development in the future but there was concern from collaboratives about their sustainability. While they had made progress there remained a need to consistently push for primary care providers to have an effective voice in system and place level decision-making.

Background

The new government has set out an intention to move care closer to home, with a shift of resources to primary and community care. Primary care provider collaboratives, which bring together providers of primary care services, offer a unique opportunity to deliver care closer to home. They have the potential to address unwarranted variation, provide a supporting infrastructure for general practice, and support greater integrated working with system partners, through design and delivery of services.

Nascent in form, these collaboratives are burgeoning at place and system across England, creating agile solutions for system partners and integrated care boards (ICBs) to engage with and integrate primary care as a unified service provider. And they are opening up opportunities to drive transformation.

While primary care provider collaboratives possess an abundance of potential, without dedicated investment and resource to support their development and ensure parity with other collaboratives, they risk faltering at the starting line.

To date, national guidance has not been produced and existing guidance on other forms of collaboratives has not been inclusive of their membership, creating variation in what primary care provider collaboratives look like, what they do and how they operate. Little research has been conducted on their progress and what is needed to enable them to thrive.

To fill that gap, the NHS Confederation’s Primary Care Network has engaged with primary care provider collaboratives to track their development so far and identify what might be needed to provide the best chance of success. 

This report – informed by interviews with 20 leaders in collaboratives and two roundtables with wider partners, including ICB directors of primary care, involved in their formation – provides the first assessment of primary care provider collaboratives’ structures, their future ambitions and what is needed to support their future development. 

Based on the insights, it puts forward a set of recommendations for national and local leaders. It will be of interest to people working in primary care, integrated care boards and NHS England and is intended to show what primary care collaboratives have achieved, their future potential and what is required to achieve that potential. 

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