5. Collaboration for system integration and public sector reform

In a slightly different set up across some systems, provider collaboration is evolving beyond coordination into whole-system integration and public sector reform. Greater Manchester Alternative Provider Collaborative (GMAPC) is a registered Community Interest Company (CIC) made up of over 80 social enterprises, charities, and profit-for-purpose organisations that deliver NHS and public health services across the region, including the Greater Manchester Urgent and Primary Care Alliance, mental health, community and children's services. GMAPC operates within a devolved system architecture supporting place-based working, with system-level leadership and integration, particularly in neighbourhood health. Their current focus is on:

• integration across health, social care and children’s services, including supporting providers to enter and shape social value markets
• expanding collaboration across sectors such as residential children’s care, where there is growing interest in developing alternatives to private equity-led models and supporting wider conversations about value, accountability and profiteering in health and care services
• development of system-wide urgent and emergency care models, including a single ambulance system
• continued mutual support across organisations, enabling a coordinated and values-led system response.

Over the past 12–18 months, GMAPC has progressed integrated service models including eye health and expanded delivery into community and social care settings, while maintaining strong system collaboration. This has been enabled by devolved powers, strong system leadership and a shared system identity, allowing work beyond organisational boundaries.

Looking ahead, GMAPC is evolving into a system-level delivery and reform partner, focused on neighbourhood care, cross-sector delivery and system-wide commissioning. 

Key takeaway

GMAPC demonstrates how provider collaboration can enable system leadership and integration at scale, moving beyond programme delivery to support wider system reform.