January 25, 2019

Independent Healthcare and the NHS: Partnerships

by Carl Stevenson

At the end of 2018, Practicus coordinated a roundtable – hosted by Alliance Healthcare – that brought together leaders from independent healthcare providers and the NHS. It’s focus? To look at creating more effective partnerships.

It’s difficult talking about partnerships between the private and public healthcare sector. Throughout the seventy years of the NHS, it has always been controversial. Of course, services like dentistry, optical care and pharmacy, have been provided by the private sector for many years and technically, most GP practices are private partnerships. This much is fairly forgiving territory to discuss. But when the topic touches on outsourcing, the giving of contracts to the private sector to run NHS services, there’s a very different level of sensitivity. This roundtable wasn’t about increasing the privatisation of the NHS. But it was about looking at opportunities for the two sectors to partner more effectively under current strategy and policy.

What does partnership mean?

“Partnership” is often accused of being a throw-away term. It’s no different in healthcare, as one Managing Director commented on the day, “There are so many contracts that present purport themselves as an opportunity to partner but when you scrape back the bid documentation and project materials, you find it’s usually just a supply contract.” So we spent some time defining what we all meant by partnership, here’s a selection:

Identifying opportunities for partnership

While some on the independent healthcare side were pessimistic about increasing opportunities for true partnering with the NHS, others were upbeat.

Integrated care and whole system thinking

Many attending, particularly those from the NHS, believed changes towards integrated care and whole system thinking were actively increasing the opportunity for partnership with the independent sector as well as amongst NHS organisations:

Leverage the data

Several in the room believed that the ability of independent providers to pool data from across locales and countries is powerful, both for unearthing opportunities and to enable strategic commissioning decisions with confidence:

Expertise with capital

Others looked not to the independent sectors skills in brokering but rather their expertise around capital and ability to deal with financial institutions:

Cautionary note on outsourcing:

What makes for a good partnership?

The main recurring theme for making a good partnership was governance, in particular joint-governance:

A clear opportunity for improvement, suggested with significant support around the room, was that, “Governance has been pushed down to about lab level purely clinically focussed and it needs to be a priority at a higher and more encompassing level. We’ve got to try and drag it out and back up in the relationship.” The point here was not that clinical governance is of low importance but rather that governance of all types should have a higher priority in the relationship and it should be more than just the clinicians involved.

There was also several who noted that contracts had to be even handed in order for partnership to flourish:

Equally, honesty and openness are key:

Research is often critical:

The importance of clinicians to establishing a partnership

Everyone agreed on the importance of the role of clinicians in establishing a true partnership: