Making services more effective and efficient through collaboration and integration

We want to make health and care services in Coventry and Warwickshire more efficient, effective and ensure they provide better value for everyone. 

We will only be able to do this if we develop the ways in which we work together and the structures of our health and care system, so we have right mechanisms through which to collaborate and integrate. These should enable us to develop new ways of working, speed up processes, share good practice and resource and align high standards. Clarity is required in the roles and responsibilities across each component and in the links between all parts of our new system.

A more joined-up commissioning and coordinated provision approach, closer to patient communities, will deliver a more efficient health care service. It will also provide a more coherent response to local population needs, supporting improved outcomes for all and reducing inequity in access and outcomes across Coventry and Warwickshire.

Key to achieving this will be the strategic leadership work of our ICP, the leadership and commissioning role of our ICB and the work of our care and provider collaboratives organising local delivery of services. This will enable us to transition to an infrastructure where decisions can be taken closer to communities, with better understanding of those communities and their needs, supporting collaboration between partners to address inequalities and improve outcomes in physical and mental health and wellbeing, and sustaining joined-up value for money services.

What are we doing already? 

The Health and Care Act 2022, and other statutory guidance, sets out a clear intention of a more joined-up approach to health and care built on collaborative relations; using the collective resources of the local system, NHS, local authorities, the voluntary sector, and others to improve the health of local areas.  

Our operating model has a number of core components, which we have been establishing and developing, with specific roles.

• Integrated Care Partnership – a partnership of key health and care leaders across Coventry and Warwickshire with specific responsibilities to develop this Integrated Care Strategy for the whole population. 
• Integrated Care Board – taking responsibility for ‘strategic commissioning’ and leading integration in the NHS to bring together all those involved in the planning and providing NHS services to take a collaborative approach.
• Three provider collaboratives with distinct roles and responsibilities to facilitate the sharing of expertise, knowledge and skills between providers and to draw on the strength of its members to redesign service delivery and develop new models of care: 

Acute Provider Collaborative
- Focus on at scale Acute pathway redesign
- This collaborative will bring together all key stakeholders including Acute and other appropriate stakeholders e.g. Primary Care

Mental Health Provider Collaborative
- This collaborative will bring together mental health partner providers to respond collectively to improve delivery of mental health services across the system

Primary Care Provider Collaborative
- This collaborative will bring together all core Primary Care providers at a Coventry and Warwickshire level
- This has commenced with General Practice at present but over time wider core Primary Care providers will also be incorporated.
- The immediate focus of this collaborative will be to provide strategic direction and support to local PCN programmes.

• Two geographical Care Collaboratives which will have an influencing responsibility on commissioning decisions made by the ICB so that services can be developed and tailored to meet local population need. As Care Collaboratives develop and mature, this responsibility may increase to direct commissioning responsibility for an agreed scope of services:

- One for Coventry, one for Warwickshire. The Care Collaboratives will map to our Local Authority (LA) boundaries recognising the opportunities for deeper integration and collaborative work on health inequalities and the wider determinants of health in the smaller, contained footprints of the local authorities
- The Warwickshire Care Collaborative will be made of three equal Place partnerships. 

 

What will change in our ways of working?

• We will have a whole-system approach that is reoriented to focus on keeping people healthy, well and in control of their lives.
• We will build a sustainable system in which every resident of our area can expect to receive high-quality health and care services when they need them and barriers that currently prevent or hinder joined up care across services have been broken-down.
• Everyone in the health and care system will work together to do the right thing for our population and the right thing for the system, where the health and care workforce feel valued and supported.
• We will take collective decisions closer to the patient, based on a shared understanding of the local population and how people live their lives in a system that looks beyond health and care services to the wider determinants.

 

What actions are we prioritising?

• Getting the structures and governance of our system right, making them lean, effective and efficient.
• Developing the strategic leadership capability of our ICB and ICP.
• Developing the capability and capacity of our Care Collaboratives and local care partnerships as vehicles for driving collaboration and innovation. 
• Setting conditions to create greater collaboration, removing barriers to integrated care to allow local partnerships to thrive, and empowering staff and communities to deliver the ambitious service changes needed within the system.
• Empowering the right groups of people with the expertise and evidence to make decisions on how to redesign and reorganise services. 
• Ensuring that there is agility and pace in decision making to enable transformation to occur at the rate that the system needs.