New collaboration push in primary care opens door for Pharma, MedTech, and Devices firms

The NHS Confederation has just published this article on Primary Care Provider Collaboratives (PCPCs). It’s a great starting point for Pharma, MedTech, and Device companies to understand how they work.

But what it doesn’t tell the industry is how to get involved and where the opportunities come in – and it is absolutely crucial that they get to grips with PCPCs.

Goodbye competition, hello working together

Most of them will be aware of the provider collaboratives, the partnerships that bring together two or more providers of NHS services, i.e. hospital trusts or mental health trusts. They’re designed at scale for the benefit of the population they serve.

There are many providers who work in that way, but for the last two years, there’s been a move to formalise that way of working and to bring greater scale to it.

The big push is a move away from organisational autonomy – where the providers would work independently and compete against each other – to drive the collaboration and working agenda.

This shift was designed to address the significant challenges that we have in the NHS right now and which I’ve spoken about many times – they are drowning in workload, and the demand for services vastly outstrips the supply available due to chronic workforce challenges.

A lot of that is due to the prolonged funding squeeze that we had between the banking crash of 2008 and 2020, where the NHS was getting a two per cent budget increase per year when it really needed four per cent.

Primary care is crying out for unity

So alongside the provider collaboratives, there was a requirement for General Practice to have a voice and to be part of a primary care provider collaborative.

They are no different, the primary care system is facing the same challenges of increasing demand, the workforce crisis, estates running out of space and a lack of new models of care and innovation.

So, the PCPC has been developed and designed to support the integrated care systems, to provide a much-needed voice for primary care at system level.

That needs to be a single voice, we can’t have 119 General Practices all within one integrated care system all shouting for different things – and that’s where a PCPC would come in.

PCPCs need to be on a solid footing

One problem is that not every Integrated Care Board (ICB) has got a PCPC because without a real commitment to develop and the ability to resource and maintain the collaborations, there’s a risk that they could be set up, fail and disappear. They could also not do the job they were intended to and never properly get off the ground.

The ICBs need to be seen to be working with PCPCs because that’s how they get the commitment from primary care to actually put the time in to make it work.

I’m talking about a system-wide General Practice approach. We’ll still have the Primary Care Networks, the integrated neighbourhood teams from the Fuller stocktake when that’s all fully implemented, and we’ll continue to have the GP Federations.

But this is about the collaboration between all of those different voices to create a single voice for General Practice when it is required.

One voice cuts out the risk of top-down management

A strong voice for primary care/General Practice at system level is absolutely essential if we are going to address the system priorities and base them around the local needs of the population and what matters to them.

If we don’t have a single voice for General Practice, nobody then knows who to talk to from a General Practice perspective and often what happens is the main provider collaboratives between, for example, hospitals and mental health trusts, will just make decisions and carry on.

That runs the risk of General Practice facing the unenviable task of having decisions made on their behalf that they’ve got no influence over that they’re then expected to get on with and deliver.

Often, the NHS utilises top-down command and control where we have a small sub-committee who make decisions and then tell everybody else where they’re going wrong – a system fraught with risk and danger. Even the best ideas are going to meet resistance because people don’t own the problem or the creation of the solution, so they’re going to block it and get in the way.

I think the best way of delivering change is to have an open call to everyone who has an interest in the change to come along and lead it – own the problem, create the solution, and guarantee implementation.

A model in the Midlands

There’s an example here from my online learning module.

This is the Coventry and Warwickshire integrated care system. It gives a full picture of 119 practices forming 19 Primary Care Networks that work through groups of four local GP limited companies/federations, approaches that then connect into the PCPC.

They then connect to the four-place footprints of Coventry, Rugby, North Warwickshire and South Warwickshire.

The thing to notice there is that Rugby is a place footprint despite the fact it’s only 54,000 patients because there’s a Rugby Borough Council. The place footprints are the local authority footprints and that ensures the local authority has a say in how services are commissioned and provided.

This example shows the PCNs and the GP Federations are already delivering at scale across the practices, the networks and those federation place footprints. But now, delivery of a system-wide approach is being asked for to allow services to be commissioned at system level that can then be sub-contracted from that system down through the local GP Federations, through the networks and then through the General Practices.

Four goals to aim at

The key for Pharma, MedTech and Device companies is to remember that all of this is driven by the shift away from the focus on competition toward a new model of collaboration and integration.

It is designed to deliver four key goals for the integrated care system:

1.      Improve outcomes in population and healthcare.

2.      Tackle the inequalities in outcomes and experience.

3.      Enhance productivity and value for money.

4.      Help the NHS support broader social and economic development.

This provides a great opportunity for industry because we could start a project in one practice, scale it across one primary care network, then grow it across a place footprint and then grow it from there into an integrated care system.

I cannot find examples of an integrated care system doing something across all the General Practices in one go. But somewhere along the line we’ve got to start with a small scale and grow it from there; that’s where the provider collaborative could really help.

Accessing the people who sit on the provider collaborative for primary care is a route to potentially piloting in one network or maybe even starting in just one practice.

Read my blog on Six Ways To Win An Audience With The NHS here.

Get on board with the NHS Long Term Plan

This is all geared around pursuing the three aims of the NHS Long Term Plan – better health and wellbeing, better quality in healthcare and, the big one, ensuring the financial sustainability of the NHS. That’s what we’re trying to do by creating these bigger provider collaboratives that then implement one high quality, standardised approach without any unwarranted variation.

The focus is on the right patient being seen in the right place at the right time by the right healthcare professional who has got the resources to deliver the care required.

So it’s really essential that the industry gets to understand the PCPCs and then, as many of those are already starting to connect into the bigger system provider collaboratives with the hospitals, there’s a great opportunity to shape how services are both commissioned and provided.

Scott McKenzie helps pharmaceutical, medical technology and appliance firms increase revenue by getting their products and services in front of the right NHS decision makers. If you want to get your products fully embedded into treatment pathways we can help you. We’ve doubled revenue for our clients and can share these processes with you too.