Chapter 10 - Introduction
As set out in Chapter 6: How do we innovate a new model of care working with users and carers? coordinated, person-centred care requires multi-disciplinary teams working together to address all of an individual's needs. Multi-disciplinary teams require multiple providers working together. For multidisciplinary teams to function effectively, providers will have to make decisions together about budgets, goals, and management. There are a number of options for forming networks, which vary in the level of integration they facilitate.
Provider networks should bring together primary care (with GPs at the centre of coordinating people's care) alongside social, community, mental-health, third sector, acute, and specialist providers. However, GPs will first need to form their own primary care networks in order to reach a scale that allows working together with other providers. More information on GP Networks, including their benefits, potential structures and how GPs can begin building them is available in Chapter 9: How should GP networks be developed?
Forming effective provider networks will be challenging because tough decisions will need to be made to deliver better care in a model where, to meet population need more effectively, some organisations will expand and others will become smaller. It will be crucial to adopt a mindset that focuses on service users, their outcomes and how the integrated team works together, rather than how individual providers perform. Having co-production with service users and carers as a continuing first principle will help facilitate this.
This chapter outlines the options for provider network structures and issues providers must consider to support integrated teams, such as effective decision-making, performance management and sharing risks and savings. It is built on the assumption that commissioning budgets are pooled (as per Chapter 7: How can we commission integrated care?) and that funding is allocated to provider networks on a capitated basis Chapter 8: How can commissioners align provider incentives?). Detailed commentary on the legal implications of these options is available in Supporting Material G: Legal Issues Compendium.
This chapter explores how providers can form networks on the assumption of pooled commissioning as described in Chapter 7: How can we commission integrated care? and with capitated payments as described in Chapter 8: How can commissioners align provider incentives?