4. Reconfiguring services for the future through networks, consolidation and scale

Beyond immediate performance improvement, provider collaboratives are increasingly being used to support longer-term pathway redesign, particularly in response to workforce and financial pressures.

In West Yorkshire Association of Acute Trusts (WYAAT) which includes six acute providers, a system-wide review was carried out and has established a clear framework for how services should operate across different levels:

• place-based services for locally integrated care
• services planned and delivered across geographical partnerships to improve productivity and maximise access
• networked services to improve equity and consistency
• specialised services consolidated for quality and sustainability. 

This framework is now being translated into delivery, including redesigning clinical pathways including neurology, consolidating services such as microbiology labs, networking procurement services, implementing shared infrastructure including a single aseptics manufacturing unit to serve all trusts and single instance digital systems, and developing shared assets such as diagnostic and elective hubs. Crucially, this work is underpinned by a much stronger focus on benefits realisation, linking collaborative activity through medium-term plans directly to:

• financial outcomes – with an opportunity in the region of £40 million of financial benefits, both cash and non-cash releasing
• workforce impacts – including expanding shared network roles and reduced reliance on high-cost temporary workforce solutions
• access and performance improvements. – collaborative initiatives as an enabler to the delivery of medium-term planning performance targets.

Key takeaway

Provider collaboratives, including WYAAT, are increasingly being used as the mechanism through which difficult system decisions are made and delivered about where services should sit.