NHS-led Provider Collaboratives: specialised mental health, learning disability and autism services

The NHS-led Provider Collaboratives model is based on what were formerly known as New Care Model (NCM) pilots. These pilots trialled new ways of working across mental health NHS trusts within local areas. The pilot sites provided specialised mental health services with the aim of reducing the number of people who were cared for out of area and creating the services their population needed through local re-investment. Thanks to its success, this approach is now being rolled out nationally.

As detailed in the NHS Mental Health Implementation Framework, from April 2020 NHS England and NHS Improvement aim to mainstream the New Care Models approach for specialised mental health, learning disability and autism services, enabling local service providers to join together under NHS-led Provider Collaboratives. These will be responsible for managing the budget and patient pathway for specialised mental health care for people who need it in their local area. To begin with, Provider Collaboratives will deliver:

  • Child and Adolescent Mental Health services (CAMHS),
  • Adult Low and Medium Secure services
  • Adult Eating Disorder Services.

NHS-led Provider Collaboratives will include providers from a range of backgrounds, including the voluntary sector, other NHS trusts and independent sector providers. Provider Collaboratives will work closely with established partnerships called Integrated Care Systems, which include NHS organisations, local councils and others, to support improved commissioning of services for people within the same population footprint. They will also work alongside service users, carers and families.

The ambition is for Provider Collaboratives to:

  • Improve continuity in patient pathways and ensure that financial incentives are focused on high quality and clinically effective patient outcomes.
  • Make services locally- and clinically-led, giving local health systems the freedom to innovate to improve services, whilst maintaining national consistency in clinical standards and quality.
  • Continue to reduce inappropriate out of area placements, avoidable admissions and lengths of stay; and to improve outcomes and experience for people using services, their families and carers.
  • Where admissions are required, they should be short, close to home in a high quality, safe and therapeutic service
  • Improve value for money in specialised mental health spending and reinvest savings in community and step-down services, and links with the criminal justice system.
  • Create a basis for and achieve further integration with other local commissioners and locally-commissioned mental health services.
  • Reinvest savings made through improvements in care such as reduced out of area placements into community services for the local population.

We want systems to plan for NHS-led Provider Collaboratives to become the vehicle for delivering all appropriate specialised mental health, learning disability and autism services over the next five years. Systems will align with service reviews in adult secure and CAMHS specialised services, fulfil the NHS Long Term Plan inpatient ambitions for people with learning disabilities and autism, and roll out specialist community forensic teams.

Selection process

The selection process for lead providers and their Provider Collaboratives involves two stages: Selection (May to July 2019); and Development and Approval (July to December 2019). As part of stage one, following assessment, initial submissions were placed on one of three tracks (fast track, development, or further development). As part of stage two, providers are working together with support from NHS England and NHS Improvement to develop detailed submissions. These will be assessed against approval stage evidence requirements and submitted in November 2019.

Scope

The following services are part of this selection process:

  1. Adult Secure: Adult Low and Medium Secure Mental Illness, Personality Disorder, Learning Disability and Autism Services,
  2. CAMHS: General Adolescent, Psychiatric Intensive Care Units (PICU), Specialist Eating Disorders Units, Low Secure; Low Secure Learning Disability and Autism services Community Forensic CAMHS,
  3. Adult Eating Disorders.

The following services not included in this process are likely to be part of Phase Two, which will be subject to further provider selection processes from 2020:

  1. Adult Secure: Adult Low and Medium Secure Acquired Brain Injury, Secure Deaf and Women’s Enhanced Medium Secure. High Secure (commissioning for High Secure services being considered as part of the High Secure Commissioning Plan),
  2. CAMHS: Children’s (under 13s), Medium Secure and Deaf,
  3. Specialist Services: Obsessive Compulsive Disorder, Body Dysmorphic Disorder, Tier 4 Personality Disorder, non-secure Adult Deaf,
  4. Perinatal inpatient services.