Hospices and Integrated Care Systems: collaboration

In September 2022, Hospice UK provided evidence for the UK Government's Health and Social Care Committee's inquiry. This considered how Integrated Care Systems will deliver joined up health and care services to meet the needs of local populations.

This two-part series is based on Hospice UK's submission.

Written by Annette Alcock, Head of Health and Care System Relationships, Hospice UK.

Understanding the system and building trusted relationships takes time and resource. Wider system partnerships require a collaborative approach from hospices.

Often undertaken on top of busy day jobs, collaborations start as an ‘alliance of the willing’ and are funded by individual organisations. 

Large structures have multiple decision-making layers of boards and committees. Representing others at the table and contracting jointly for services requires robust governance and transparent risk-sharing. But being at the table doesn’t automatically translate to more funding. And more funding comes with more reporting. 

The health and care system may be complex and bureaucratic, but it is battling to transform and improve. Innovative and flexible partners, such as hospices, are often the solution.

There are many reasons to collaborate: 

• better use of scarce resource, 
• sharing similar functions, 
• speaking with a louder voice, 
• providing services across a wider geography. 

In local PEoLC committees, hospices may sit as individual providers, but in regional health boards, they may be required to represent larger interests.

Equally, collaborations, partnerships, and alliances can be made up of a variety of providers, depending on the voice they want to amplify. 

Whether it is the voice of the voluntary sector or that of communities and people, hospices still have the remit and role to ensure that care takes account of everything the non-statutory sector has to offer.

Even then, the reasons to be at a system planning table might include:

• Raising the priority of end of life care in strategy discussions;
• Ensuring the planning and funding takes account of system-wide, accurate population, workforce, activity, and outcome data;
• Designing models of care with specialised clinical knowledge and the voice of lived experience;
• Offering service solutions as an alliance across hospices, end of life care providers and / or the voluntary sector. 

It is providers who must form the necessary alliances and partnerships. However, Hospice UK joins the call on statutory bodies to ensure that these are resourced, engaged and recognised as partners of equal parity in planning, decision making and service delivery.  

In order to bring the knowledge to the table and be part of the resulting solutions, hospices will need to build up the following:

• Find and build trusted relationships with system leaders and influencers, from NHS body managers who make funding decisions, to clinicians who lead system clinical networks or committees in end of life care;
• Work closely with system partners, including other hospices, local GP practices and care homes, local hospitals, and a wider remit of health and care voluntary organisations;
• Know your data and value to the system and be able to articulate it to variously informed audiences with vast arrays of pressing priorities and needs;
• Prove the innovation and flexibility of hospice or alliance-led solutions to these needs;
• Have the structures and governance within alliances for legitimate and wide-reaching representation and / or a strong and united voice that simplifies relationships and transactions for system partners.

Examples of hospice collaboration

Take a look at how hospices are collaborating in our Examples of Innovation Directory.

Whilst hospices have a unique role in healthcare and a favoured place in communities, by working with the wider health and care system they can deliver more sustainable and joined up care for the benefit of both patients and hospices.  

Likewise, systems who enable those at neighbourhood level to have a true voice in system level planning will find that their co-produced ideas are more easily implemented for the benefit of our populations.