Ten hospices in West Yorkshire have formed a provider collaborative, aiming to work together to provide the best possible palliative and end of life care (PEoLC) to people in the local community. The hospices are:
Forget Me Not Children’s Hospice
The Kirkwood Support Life
Marie Curie (Bradford)
Martin House Hospice
Overgate Hospice
Prince of Wales hospice
St Gemma’s Hospice
Sue Ryder Manorlands Hospice and
Sue Ryder Wheatfields Hospice
Wakefield Hospice
Hospices are an integral part of the PEoLC system, and the collaborative works with local partners to improve quality of care, develop more integrated services and widen access.
The aim has been to ensure the West Yorkshire Integrated Care Board (ICB) recognises PEoLC as a priority and secure fair and sustainable funding for hospices. This will enable PEoLC provision in West Yorkshire to keep up with demand.
Outcomes
The collaborative is one of four Provider Collaboratives in the West Yorkshire Integrated Care System (ICS). This means they have a seat on the System Leadership Executive Group and Partnership Board, and take part in key conversations around priorities and funding.
They have been able to raise awareness about the potential of the voluntary and community sector (VCS) to support health services. The ICS commissioned a report about the social value of the VCS, which the hospice collaborative fed into.
The hospices have also educated ICS colleagues about finance and risk, explaining what it means for a hospice to be in deficit and how this has an impact on the need to grow services.
As a provider collaborative, the hospices take part in system-wide initiatives and discussions about topics such as anti-racism, climate change and cost of living. They also have the opportunity to use integrated data systems such as RAIDR.
Facilitators, challenges and advice
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Key facilitators
The hospices in the collaborative have developed a strong mutual understanding of each other’s models of care, ways of working, and service development. There is a recognition that although they all use different models, they are working towards the same outcome. This means they are able to offer each other support.
For example, when one hospice in the group had to temporarily close a service, they were able to move staff to another hospice so that there were no redundancies and no loss of skills.
All the hospices in the collaborative share intelligence with each other. This means hospices can identify trends in discussions that have taken place separately, and work out negotiation strategies.
The hospices received a sum of money from the ICS, to help them set up and develop the provider collaborative. Hospices in the group have also found that charitable donors and supporters feel positively about the idea of a collaborative.
Challenges
In the past, the hospices in the collaborative have not always been treated consistently where funding is concerned. The group has worked hard to improve consistency and uniformity of contracts.
Colleagues in the ICS had a strong understanding of how finances work in the NHS, but less experience of charity sector funding or the differences between adult and children’s hospices. The hospices have worked to educate them on this and standardise funding agreements.
It takes a significant amount of time to set up a collaborative and develop relationships with ICS colleagues. The hospices have taken a ‘risk vs reward’ approach to this, and are starting to see the benefits of having a stronger voice in the system.
Tips and advice
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Be transparent with each other about where your funding comes from and what your challenges are. This will build trust and enable different types of hospice to work together.
Hospices are small, pioneering organisations that can work more flexibly than the NHS. Show your ICS colleagues examples of how you can do this.
Align yourself with ICS priorities – this will keep the door open.
Develop strong key messaging about the financial impact of hospice services. The West Yorkshire Hospices make it clear that for every £1 the ICS invests, the collaborative can deliver £3 of value. Using this messaging consistently helps ICS colleagues to understand the efficiency saving of investing in hospices.
Future development
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The collaborative has secured a commitment from the ICS to develop a five-year sustainable funding plan, which will begin in 2024. The understanding is that the collaborative will develop a proposal for this.
The hospices are working together to shape a campaign that will help identify patients and families who need palliative and end of life services earlier on in their care journey. This will help avoid admissions into hospital, promote safe and early discharge and empower people to make choices about their care, backed by Advance Care Planning.
To continue building stronger relationships, the hospices are planning to open up their meeting rooms to ICS colleagues. This should also help improve colleagues’ understanding of hospice services.
