Seven hospices in Humber and North Yorkshire have formed a collaborative and signed a memorandum of understanding (MOU):
St Michael’s Hospice, Harrogate (administrative lead)
Dove House, Hull
Lindsay Lodge, Scunthorpe
Martin House Children’s Hospice
St Andrew’s Hospice, Grimsby
St Catherine’s Hospice, Scarborough
St Leonard’s Hospice, York.
The hospices have invested in a job share consultant role, which is tasked with helping them operate more effectively and efficiently. This role has been in place since February 2022.
A key part of the consultants’ role is liaising with the integrated care system (ICS) on behalf of the collaborative.
Outcomes
Having the consultants in place has enabled the collaborative to start developing productive relationships with the ICS Chair, CEO, Clinical and VSCE leads. They have been invited to become involved at the place based and regional level and are able to put forward a strong and coherent message about hospice care. The ICS seems enthusiastic about the work of the collaborative, as it gives them a single point of access to several hospices.
The consultants are working with hospices to improve efficiency across the collaborative. This includes strategic planning, measuring impact and advising on what might be plausible and possible for the future.
Facilitators, challenges and advice
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Key facilitators
Although the seven hospices in the collaborative have different circumstances, there is a clear understanding from all the CEOs that they need to work together to get their voices heard in the wider system. The collaborative has followed Charity Commission guidelines regarding collaboration and takes measures to help ensure everyone has an equal voice. The memorandum of understanding (MOU) provision to overcome any disagreements by allowing individual hospices to step back from activities if they wish.
The integrated care system (ICS) has been receptive to discussions and keen to have the collaborative at the table. This is partly due to individual hospices working hard to build relationships with commissioners before the collaborative was formed.
Having a job share for the consultant role means that the collaborative can benefit from a wider set of skills than might otherwise have been possible. It also means the two consultants are able to provide each other with peer support.
Challenges
Hospices fit into different elements of the system landscape – including the health care and charity sectors. Whilst this can be a strength, it also means there is potential to fall between the cracks. Being proactive about engaging with the ICS can help overcome this.
The ICS is keen to improve palliative and end of life care across the whole system, and hospices have had to recognise that this involves other providers and points of view. It may require hospices to be flexible and change ways of working.
When the collaborative began, staff in some hospices had to be reassured that this was not a way to merge hospices/cut costs through redundancies but rather a way to strengthen hospices’ voices and work more effectively.
Tips and advice
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When approaching commissioners you need to speak the same language. They are looking for ways to transform the system, so show them the innovative ways you deliver care. Don’t just ask for money! Find out their priorities and show how you can help – for example by reducing hospital admissions. Use evidence to demonstrate that hospices are a key resource and show the breadth of services you can offer.
Things do move slowly and it takes time to build relationships – this doesn’t mean that you haven’t been successful.
If you’re starting a collaborative from scratch, it’s important to have a formal mechanism to ensure all participants have the same aims and are moving forward together. Every hospice is different but there are also lots of similarities.
Future development
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The integrated care system (ICS) is in an early stage and the collaborative plans to build on its position to become a recognised and respected strategic partner. The collaborative will also investigate more ways to work together more effectively and efficiently.
