Dorothy House Hospice has developed a progressive model that enables them to explore opportunities for collaboration in a way that benefits all parties.

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The challenge

There is a strong case for collaboration within the hospice sector. It allows hospices to:

  • improve services by sharing learning and best practice
  • achieve economies of scale and maintain services standards while costs are rising
  • act together to influence decision-makers.

In England, the NHS commissioning landscape expects service providers to collaborate within integrated care systems (ICSs).

However, there can also be a reluctance to collaborate. There can be an assumption that any collaboration will result in loss of independence and brand identity – or even a merger.

Progressive collaboration

Dorothy House hospice has developed a model of progressive collaboration, which enables them to explore partnership working with other organisations in a way that is beneficial to everyone. 

There are five levels to the Progressive Collaboration model. Organisations do not have to move through these levels unless it benefits all parties, including patients and families.



The Progressive Collaboration model has had strategic, tactical and pragmatic benefits for the hospice.

It encourages shared best practice, raising standards for all, and creates a friendly and consistent language for engaging in exploratory discussions. It is low risk – it allows conversations to begin at any point and progress at different paces, but this only develops into collaboration if everyone benefits from it.

Using the model enables Dorothy House to show commissioners that they have a plan for shared patient care and consistency, whilst protecting their brand identity.

Tips and advice


Use the Progressive Collaboration model and language to help open discussions with other organisations. Invite local decision-makers and commissioners to share their perspective.

Understand what you bring to collaboration and what you need from it. Define your ‘red lines’ and be open about them.

Find out more

Brian Mansfield (Trustee, Dorothy House Hospice) and Wayne de Leeuw (CEO, Dorothy House Hospice) explain how the Progressive Collaboration model works and how hospices can use it.