This article was first published in HealthInvestor.
Last week the National Audit Office concluded that, despite the exceptional circumstances in dealing with Covid-19, “standards of transparency” had not been “consistently met” in the way private sector contracts were awarded during the first wave of the pandemic.
Independent providers of health and care services to the NHS and local authorities have spent many years building partnerships, shared processes and trust to provide high-quality services to health systems, their patients and staff.
What impact has the past six months had on those relationships? As we emerge next spring – and the hard work of rebuilding not just our health system but our whole economy begins – will we look back and think it has been a positive catalyst for greater cross-sector partnerships? Or do some of the crisis manoeuvres we have seen pose a longer-term threat to the very notion of partnership?
Opinion among service commissioners seems to be split. While some view the crisis as a unique situation bringing opportunities for new types of conversation with external parties, others have adopted more of a siege mentality during Covid-19 and are unresponsive.
Rightly so, there has been plenty of reporting and public conversation about the heroic response of NHS front line staff to Covid-19. However, there has been far less recognition of the contribution from other parts of the system – the unsung heroes who ensure that the most vulnerable people still receive community support; that people are being discharged safely and efficiently back home or to other care settings; or the independent providers who signed up to a block contract to backfill NHS care in a bid to support the front line Covid-19 effort.
ZPB brought together a group of senior leaders in the independent health and care sector – from community services to acute providers, outsourcing giants and staffing providers – to discuss some of these issues. By collecting these experiences during this critical period, we hope to highlight future challenges and the unintended consequences of the UK’s response to Covid-19 as well as to share ideas on how these challenges could be addressed.
The following shifts and trends were identified by the service providers as consequences of the health and care sector tackling the pandemic:
How should the future look?
Free thinking is the most important common factor in those who engage in constructive dialogue with independent providers. There are some real innovators in the NHS, particularly among trusts embracing technology. Likewise, there are some exemplars in service delivery. These include an initiative currently being delivered by an independent provider on behalf of the NHS to transfer elderly dermatology patients from acute to primary care. Refreshingly, it is based on collaborative working between primary care networks, community trusts and acute trusts. In these instances, it’s usually force of personality that drives change rather than the system.
Independent providers have a willing role to play in ensuring good procurement that can happen at pace. They can work with government to help define this, based on providing the right services for the right population at the right time. In this way, we can have a system fit for the future.
ZPB’s take on partnership is that successful working with the NHS has to bring a quadruple win – for patients and the public, for the health and social care system, for providers and for taxpayers. This can be achieved only if combined public and private services are fairly and effectively mobilised.