Primary care collaboratives have an ‘abundance of potential’, but require investment and resources to avoid failure, a new NHS Confederation report has said.
The Realising the potential of primary care provider collaboratives report, published today, found there was ‘significant variation’ in the formation of collaboratives across England. While they have potential to pool resources, help meet strategic targets and provide a voice for primary care, they also need dedicated investment and resource to do this, it added.
The report said: ‘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.’
The research included 20 interviews with leaders in collaboratives and two roundtables with wider partners including ICB directors of primary care.
Leaders said collaboratives held a role of providing a coordinated voice for primary care within their system, and to have strategic input into their future. However, many were frustrated about the current role of primary care at place level, with some calling for them to be ‘leading the place-based partnerships’.
It also found that most collectives currently focus on general practice, with only some including or planning to include pharmacy, optometry, audiology and dentistry. Others mentioned the ‘complexity’ of these different voices would be ‘hard to manage’.
Interviewees stated the potential for collaboratives to help with same-day access care, integrated neighbourhood teams and prevention or proactive care.
The report said: ‘Cross-system integration is vital to managing the elective backlog and recovery. Primary care collaboratives can play an important gatekeeper role and support large lists of waiters to “wait well”.
‘Working alongside system partners, they are helping to redesign and deliver integrated services that reduce waiting times and improve care pathways. This includes, but is not limited to, cardiology, dermatology, general surgery, gynaecology, audiology, orthopaedic and pain management.’
Given the ‘patchwork’ of primary care collaboratives across the country currently, the report recommended that all systems consider them as a mechanism to be the voice of primary care and a ‘future delivery vehicle’.
It said: ‘Collaboratives should include some core elements, but the wider functions and form should reflect local needs and the local make-up of primary care. Where GP federations exist, these can provide a useful mechanism from which to build collaboratives.’
It also recommended more support from local leaders, including investment, autonomy and independence.
‘There needs to be parity in decision-making, ensuring primary care is sighted on developments that affect it and its patients,’ it said. ‘ICBs should carefully consider how to meaningfully involve primary care collaboratives to ensure there is true partnership, for example primary care engagement at system transformation and improvement boards to facilitate system wide transformation.’
It also suggested delegating budgets and decision-making as collaboratives ‘mature’ to support the shift of care ‘closer to home’.
