Leading a place-based collaborative

Project overview

St Helena Hospice was involved in the development of the Integrated Care System (ICS) in North East Essex, with Chief Executive Mark Jarman-Howe being seconded part-time for 15 months to set up one of the three place-based alliances in the system.

The North East Essex Health and Wellbeing Alliance includes local government, NHS trusts and voluntary organisations, working together to improve population health and wellbeing. As well as being commissioners of health and care services, the Integrated Care Board (ICB) and Essex County Council are formally members of the Alliance.

A significant part of the Alliance’s work is to oversee out of hospital care. Several of the Alliance partners, including St Helena, formed a collaborative to take on contractual responsibility for delivery of integrated community services such as district nurses and home-based community services (this includes providing equipment people might need on a temporary basis). The contract includes a key focus on public health preventative work. 

Outcomes

The collaborative secured a £45 million, 10 year contract to deliver community services. This has given them a timeframe within which to think differently about how best to provide the services people need.

Within the scope of this contract, there is very little palliative and end of life care. Much of the work is subcontracted. Within the contract St Helena has taken on the delivery of some bridging services (home based personal care and support for people who are being discharged from hospital back into their own home). 

Although these services are not ‘core’ for the hospice, they are closely aligned with the hospice’s core interests and have helped strengthen core services by bringing new income and economies of scale. St Helena has plans to combine the bridging service with its EOLC Virtual Ward, so it can offer a comprehensive intermediate care service.

Key facilitators

Having a key role in the development and leadership of the place-based Alliance has ensured St Helena was well positioned when the collaborative contract opportunity arose. Mark Jarman-Howe now chairs the Collaborative Leadership Team which oversees the whole community services contract.

Although the Alliance has a wide range of organisations, there are lots of common interests to explore. The importance of community engagement, planning ahead, patient choice, support for families and carers, emotional and mental health as well as physical health are well understood by hospices and provide a basis for developing broader partnerships outside the sector.

Other partners in the Alliance have also gone outside of their core work to benefit the collective and the local community. Having a population health and asset-based approach (thinking about what skills and expertise different organisations can offer) has benefited the local voluntary and community sector.

Challenges

Hospices straddle the NHS and voluntary and community sector. Within the local commissioning landscape, it can sometimes feel as if nobody quite knows what to do with us! Taking a lead role in the Alliance means that St Helena has a seat at the table with NHS providers, but it can also speak as a voluntary sector organisation.

External partnerships, including being a part of the leadership team for the Alliance takes around 50% of Mark Jarman-Howe’s time. This is a significant investment, and he has built a leadership team who he can delegate to. Without this ‘outward facing’ work, the hospice would miss out on potential partnerships, opportunities and funding.