Why primary care provider collaboratives can’t wait

Amidst the backdrop of sweeping NHS reforms, including the 50 per cent cuts to integrated care boards (ICBs), and the new government’s forthcoming ten-year plan for the NHS, primary care stands at a pivotal crossroads. These developments and the new model ICB blueprint bring the opportunity to redefine how care is designed, delivered and experienced. At the heart of this transformation are primary care provider collaboratives (PCPCs). 

The model ICB blueprint suggests a greater emphasis on provider-driven design and delivery, and primary care provider collaboratives are emerging as the next step in delivering more integrated, community-focused healthcare. Functions such as medicines optimisation, development of neighbourhood and place partnerships, and primary care operations and transformation could be adopted by mature collaboratives. These would be capable of being the place-based provider of neighbourhood health services, providing the integrator function to organise and deliver truly integrated, patient-centred neighbourhood health services, and built to deliver care closer to home. 

“…leaders are not only committed to transformation, they want to move quickly and decisively”

Through our NHS Confederation/KPMG collaboration, we have explored the emerging collaborative models across the country and, earlier this year, we brought together leaders across primary care and ICBs to identify the essential building blocks required to scale collaboratives and unlock their full potential. The ambition was clear: these leaders are not only committed to transformation, they want to move quickly and decisively. The discussions revealed what is truly needed to take their collaboratives to the next level, highlighting both the opportunities and conditions required for success. 

Why PCPCs matter more than ever

Primary care is the frontline of our healthcare system, yet it’s often fragmented and overstretched. PCPCs offer a new model, one built on collaboration, shared leadership and a holistic view of patient care. But PCPCs are more than just a way of working – they’re the infrastructure for a modern, preventative, community-focused NHS. Collaboratives can be the vehicle for taking on responsibility at place and system for neighbourhood health. By bringing together general practice, community services and wider primary care partners, PCPCs are uniquely placed to deliver the left shift of moving care out of hospitals and into communities.

“Imagine the potential of initiatives like the Elective Recovery Fund being channelled through primary care”

But PCPCs must be more than advocates. When recognised and empowered as strategic partners within integrated care systems they can lead transformational change, reducing pressure on secondary care, improving access and outcomes and delivering tailored, population-level interventions. Strong, trust-based relationships with system partners are key, enabling shared decision-making, co-commissioning and joint accountability for outcomes.

Imagine the potential of initiatives like the Elective Recovery Fund (ERF) being channelled through primary care – investing upstream to ease downstream demand, enabling earlier intervention, reducing the need for hospital-based treatment and improving patient outcomes. This is what a mature PCPC could do.

“Collaboration only works when everyone pulls in the same direction and trusts in the journey”

PCPCs aren’t just about working together, they represent a shift in how care is planned, delivered and sustained across local systems. Success depends on a clear, shared vision aligned with the priorities of the system, underpinned by strong governance, inclusive leadership and meaningful stakeholder engagement. Collaboration only works when everyone pulls in the same direction and trusts in the journey.

People first

But no collaborative can thrive without its people. Great ideas need great people to bring them to life. That means developing leaders, not just at the top, but across every layer of delivery. Demonstrating an effective leadership structure assures ICBs that the PCPC has the required capabilities for the future. Work through collaboratives should be seen as a core leadership responsibility, not a side task. Succession planning and leadership continuity are critical.

PCPCs need a strategic workforce model that empowers staff and fosters a culture of shared purpose, informed by equitable employment practices, strategic workforce planning, and enabled by rostering and deployment tools. Multidisciplinary teams should include PCN additional roles, social care and voluntary sector partners, and collaboration should be supported with strong project management and clear metrics for success.

Estates and infrastructure

Unlocking the full potential of PCPCs requires rethinking the use of existing estates. Physical space should not be an afterthought. PCPCs must co-develop joint estates plans with the voluntary sector, local authorities and wider NHS partners. This could unlock co-location opportunities, shared community spaces, and health on the high street. This approach aligns with national ambitions for housing growth and integrated neighbourhood services and makes better use of capital-constrained estates budgets. 

Additionally, innovative financing, such as through private sector capital investment, can unlock new ways of delivering care – from shared hubs to community health centres – and support long-term infrastructure.

To bring it all together, PCPCs should align their efforts using a target operating model framework that outlines the people, processes, infrastructure and ways of working required to deliver their vision. 

Redefining what’s possible

PCPCs must aim not just to co-ordinate care but to transform it, making services more proactive, integrated and equitable for every community.

The shift to PCPCs isn’t just a policy idea or a structural change, it’s a cultural one. It’s about building trust, sharing power, and redefining what’s possible in local health and care systems. The model ICB blueprint shows PCPCs have an opportunity to take responsibility for delegated ICB functions. 

The journey won’t be linear. But with clear goals, collaborative spirit and a shared commitment to better outcomes, PCPCs have the potential to reshape the future of out-of-hospital care in England – driving left-shift and delivery of a neighbourhood health service. 

Ruth Rankine is director of the NHS Confederation’s Primary Care Network. Gina Naguib-Roberts is a director in KPMG’s healthcare advisory team.