Tim Coney sheds light on the urgent need to reevaluate and ensure that patients are the core of partnerships, rather than adopting a contractual approach, consisting of performance-centric models, which is detached from the reality of day-to-day operations

The NHS works within an ecosystem that includes voluntary organisations, the private sector, and local and national government. Partnerships enable one of the NHS’s key strengths – the ability to flex and adapt. The response to the coronavirus pandemic showed what can be achieved when partners work together to remove any friction that is likely to impede outcomes.

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For the integrated care agenda, partnerships are a valuable lever to pull, and now, in the face of financial and recruitment challenges, their success is vital. In September 2022, the Academy of Medical Royal Colleges released a report that said in the current climate there is the risk that harms become “normalised”. To prevent this the NHS needs its partnerships to be innovative, disruptive, flexible, and agile to help it improve health outcomes. There is now an urgent need to reevaluate and ensure that patients, rather than benign performance metrics, remain at the core.

Building successful, patient-focused partnerships

A key contributor to the success of the NHS comes from the trust patients place in it. While at times issues such as waiting lists can stretch that bond, patient’s trust has endured and must be protected. To continue to earn the trust of patients the NHS must face its challenges by rethinking key aspects of its service delivery, including how partnerships are formed and measured.

Traditional partnership contracts have been based on performance-centric models, measured through payment plans, volumes, and service credits. This contractual approach is detached from the reality of day-to-day operations and adds friction not flexibility. The NHS is a fluid organisation, and it must have the space to adapt to meet the needs of patients. If a partnership starts with a 400-page requirements document, it’s likely to struggle to bear any fruit in the fast-paced, agile world of the NHS.

Partnerships must also be based on mutual trust with shared goals. Trust from patients, clinicians, and those who work in the NHS to provide administrative support to clinical activity is a key to success. A successful NHS partnership is built from the patient outcomes it needs to improve and developed back to the services that are required to achieve those aims. A common goal and ethos must start and finish with the patient.

The ingredients for a true partnership

At Capita, we have supported the NHS in many key areas. We understand healthcare and deliver large-scale administrative improvements in the UK and globally to enable healthcare providers to operative more efficiently and sustainably.

We believe that four important ingredients are needed for a true partnership:

  1. Values: A shared common goal and understanding of how it helps patients.
  2. Collective: A clear view of what the whole care ecosystem can enable in partnership.
  3. Evolution: A clear set of principles to guide the partnership. For example, what is local and what can be centralised, what is relationship-based and what is transactional. The system will evolve over time, but these guiding principles should endure.
  4. Measurement: A clear set of measures that are aligned to patient outcomes.

Think about what you could achieve if you were leveraging all your partnerships successfully. Perhaps, now is the time to reengage your partners and rethink your common goals?

Together, these components define the nature of the partnerships that are required and give a sense of the whole system that they are required to support. They must then flow into the procurement process. If the values and shared outcomes are diluted by adding a performance matrix and rigid requirements specifications in at procurement, the ability to innovate, disrupt, and flex to improve health outcomes is removed or at best curtailed. Performance measures are important, but they must be right ones and drive the right behaviours for the good of patients and the NHS system.

Longer waiting lists and financial challenges are putting more pressure on stretched staff. Nobody wants to accept lower standards or see harms being normalised in the NHS. Therefore, integrated care systems need to focus on the tools they have available to them now to improve patient care. By viewing partnerships as an important lever and carefully considering the principles they are built on (the needs of patients, their families and the clinical community) ICS’s can make vital progress, both in clinical care and in the essential support services and back-office operations.

What are you going to do to re-engage your partnerships? 

Think about what you could achieve if you were leveraging all your partnerships successfully.

Perhaps, now is the time to reengage your partners and rethink your common goals? Are your partnerships based on contracts not outcomes? Where is the voice of the patient within them? Are your shared goals and principles clear at every stage, including during procurement?

To continue the conversation and find out more about Capita visit our website or contact me at tim.coney@capita.com.