Driving forward system working: a snapshot of early progress in collaborative commissioning

This report draws upon the insight of leaders from CCGs, NHS trusts, national policy makers and think tanks, to explore the changing relationship between commissioners and providers in the context of system working. The report builds on our previous work on Steering towards strategic commissioning – over a year on, it is timely to review the views of our members while also considering the role of NHS providers as system partners.

Driving forward system working: a snapshot of early progress in collaborative commissioning shares practical examples of local areas that have made progress in collaborative system working, such as in Gloucestershire where local authority and CCG staff have access to the same electronic network to share information, and in Devon where a collaboration of mental health providers has succeeded in reducing out of area placements. The report finds that, while there is no single best approach to deliver collaborative commissioning, a number of common success factors are already facilitating system working:

• Strong collaborative and clinical leadership that transcends organisational boundaries and is focused on delivering care to meet the needs of a local population.
• Establishing ‘one version of the truth’ that can drive honest open and honest conversations.
• Supporting staff to work flexibly across systems, potentially pooling resources or appointing joint posts.
• Involving all system partners, including local authorities and the voluntary and independent sectors.

The report also identifies changes at the national level which could further enable providers and commissioners to navigate challenges and collaborate more freely as system partners, including:

• Aligning national policy requirements, such as regulation, financial incentives and assurance processes, with the realities of developments on the ground.
• Adopting an approach in day to day dealings with local bodies that mirrors the expectations of collaborative working.
• Offering national guidance and support to help all systems navigate in this new landscape. This involves supporting leadership, supporting risk management and governance arrangements, and continuing to support the sharing of innovative practice.

We have shared this publication with key colleagues at NHS England, NHS Improvement and other national bodies and will be discussing ways to accelerate and smooth integration with them in 2019.