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Is collaboration between the independent sector and the NHS under threat post-Covid?

This article was first published in the HealthInvestor magazine (February 2021 edition) following an online panel on 09/12/20 with Zoe Bedford chief executive of ZPB Associates, Gabrielle Silver chief executive of CHS Healthcare, Vivienne McVey chief executive of Virgin Care and Ruth Poole, chief executive of Preventx.

Panel description: 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. 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?


Independent providers of health and care services to the NHS and local authorities have spent many years building partnerships and trust to provide high-quality services to health systems, their patients and staff and have played a critical role in the national effort to tackle Covid-19. So, what impact has the past six months had on those relationships?

Accelerated thinking and ‘unbossing’
Covid-19 has in some circumstances given front line and ancillary health services more freedom to operate and with faster decision-making. Described by the panel as ‘unbossing’, local commissioning and clinical teams have – through necessity – been given more freedom to work differently, paving the way for faster decision-making and more locally focused, autonomous planning and operations. We have seen greater agility in the way that health and care providers work, with organisational, sector and geographic boundaries becoming more porous.

Much-needed protection for the social care sector
Covid-19 has highlighted the fact that the social care sector has often been overshadowed by the dominant healthcare providers, with a historic lack of investment and less involvement within internal discussions around integrated health and care delivery. The ‘new’ heightened profile of key aspects of social care and its vital role in the operating and governance structures of health systems, means that these providers must be further included in conversations. The hope for the future is that commissioners become advocates for social care providers.

As we look forward to the next five years, what could our respective roles in tomorrow’s healthcare system be?
While those working in the sector have long known this, Covid-19 has perhaps deepened public understanding that the delivery of a national health service relies on the cooperation and collaboration of a complex system of providers and suppliers. We are all players within the health and social care system, whether independent, third sector or NHS providers. The independent sector has a strong voice within central NHS and government, but that is often diluted the further we venture into regional health economies. Finding that voice and owning that sense of shared endeavour and purpose that we have witnessed in 2020 will offer a real chance to plan and provide services using everyone’s expertise in different areas. The independent sector often brings the focus on the patient or citizen to the fore, an agenda focus which can get lost when it comes to the brass tacks of contracting and procurement. It can also bring that level of honesty, focusing on improving quality of care for the patient.

The best way to preserve this cooperation and two-way partnership is for the NHS and social care sectors to identify parts of the patient journey where they need extra support – not just in capacity, but in capability and investment too – which will allow the system to align more naturally around supply and demand, skills and strengths, efficiency and expertise. By mapping this out, we will be able to take a systemic view on how best to build a world-class health and care system that can withstand serious events and crises like we have experienced this year.

By Zoe Bedford, Chief Executive