Acute provider collaboratives: delivering system impact in a changing NHS landscape

The NHS is in a period of significant transition since the publication of the 10 Year Health Plan (10YHP), which sets a clear direction for healthcare: a shift from hospital to community, from treatment to prevention and from analogue to digital, all underpinned by a stronger focus on productivity, financial sustainability and neighbourhood-based care. At the same time, changes are underway to the NHS operating model with NHS England (NHSE) functions moving into the Department of Health and Social Care (DHSC), regional teams being responsible for performance and oversight of their systems and ICBs as strategic commissioners.

Within this landscape, the need for providers to work together is no longer optional - it’s essential to deliver the NHS of the future.

Back in 2021, NHSE released the working together at scale guidance for provider collaboratives which made it mandatory for every NHS trust to be part of a provider collaborative. Now, the more flexible approach aligns with the wider push towards local autonomy and less command and control. A key benefit of this is that systems can pinpoint where collaboration delivers the most value. This empowers providers to shape partnerships independently, avoiding rigid mandates and ensuring they are not forced into collaboratives that are a poor fit or face significant operational barriers.

However, despite their demonstrated performance and clear alignment with the ambitions of the 10YHP, provider collaboratives have not been explicitly positioned in recent national guidance, which may be a missed opportunity given that delivering the three shifts will require sustained collaboration across organisational boundaries.

Throughout April and May 2026, the NHS Alliance held interviews with acute provider collaborative leaders across England to learn about where they are adding most value against the ambitions of the 10YHP and what has enabled their success.