In Conversation with Matt Brown of the North East and North Cumbria Provider Collaborative

Matt Brown has been Managing Director of the North East and North Cumbria Provider Collaborative since early 2022. He kindly agreed to share his unique insight as a leader as we proceed through the first year of our Primary Care Collaborative journey.

Representing a total of 11 NHS Foundation Trusts, with 80,000 staff serving 3.2 million people, the NENC Provider Collaborative has gained valuable experience and insight since its beginnings in the dark early days of the pandemic.

The Trusts already had a long history of collaboration, but in 2020 those relationships were formalised out of necessity, as Matt explains:

“During the early stages of Covid, it was recognised that our Foundation Trusts needed to do more together; there was a new urgency there. Demand for PPE, unified comms messages, the vaccine programme – all these factors added greater impetus to work more closely together.”

Governance was drawn up and Matt joined the Collaborative as Managing Director 2.5 years ago, a role that sees him liaising with Chief Executives to pool resources and come together to focus on elective care, clinical strategy, diagnostics, finances, workforce, estates, and other big picture areas of work. Matt explains how the Collaborative has evolved since its early days:

“Since the start of the pandemic, pressures have changed. Historically, our Trusts were able to work together but succeed individually as well. Now, there’s a definite recognition that Trusts can’t only succeed alone. They need to join forces to develop and deliver the best possible care for our populations.”

However, although the Trusts now work more closely together, they each remain very much in control of their own destiny. Although they strive to deliver the best they can for their particular workforces and populations, there’s power in knowing when to combine forces and when to work autonomously. Matt says:

“I think of the Provider Collaborative as a mechanism, rather than an organisation in itself – it’s not a separate entity. It’s the tool Foundation Trusts can use to work together when it makes sense to do so. And that isn’t all the time. In fact, the majority of the work FTs do, they do individually.”

Matt gives the example of elective care, which is mostly delivered by individual organisations in their local communities, in their out-patients departments and theatres, working with their local general practice, their local optometrists, and local communities. Like the Primary Care Collaborative, the Provider Collaborative does not take a top-down approach; rather it creates space for different organisations to come together when that is what is required to achieve optimum results.  

“There are elements of our work better done together. Where we have pathways with long waits, where some Trusts have more pressure on their waiting times than others – that tool, the Collaborative, is a mutual support mechanism that allows us, in discussion with patients, to lift the pressure, move people to improve their care and make better use of our capacity. The FTs are spotting those opportunities and making those decisions for themselves.”

When asked what has surprised him about doing this job, Matt explains that although there’s a real willingness to work together, and a palpable urge to improve things for populations, communities, and staff, it’s still hard work to make progress. He says:  

“Even with that intent in place, there are challenges. My job is to facilitate people doing the integrated work, to drive things on. But even when there is a clear mandate for change, it can be surprisingly challenging to make it happen. However, people do want it. Together, we’re building real clarity and confidence, which is exactly what I believe the Primary Care Collaborative is doing, but it takes time and perseverance.”

Matt advises a stoical approach, and not to become downhearted when not everything works first time, explaining that some of the Collaborative’s best successes have come from trying things out that didn’t initially work, building understanding, then trying a slightly different approach. For example, with the aim of increasing the fluidity with which staff could work across different Foundation Trusts, moving to ease pressures as they arose, the Collaborative began to do some work on mileage, and working terms and conditions. Matt says:

“When we got into it, we realised the Trusts had such different staffing arrangements there was no real benefit in pushing it – the systems were not easy to simplify or cohere. So, we changed focus, which is how our portability agreement came to be developed.”

The portability agreement has been something of a game-changer for the way Foundation Trusts work together, reducing the transfer time for staff on temporary assignments from around three months to just a few days.

“It’s a really practical tool that allows staff to move across organisations seamlessly, for example, so that Newcastle might provide clinics into Durham or for Trusts to share staff to support patients in different parts of the patch, depending on where pressures are. It allows any substantive member of staff from any Trust in the patch to move to any other Trust without the need to re-do mandatory training, DBS checks, reading, recruitment checks.”

Inspired by work already taking place in West Yorkshire, the Provider Collaborative pushed the idea further, giving it a legal foundation rooted in information governance legislation. The portability agreement has already gained some traction in other parts of the country. Sharing best practice is a key component of how the Collaborative works:

“It’s really important that where we’ve established things like the portability agreement, or our repatriation policy, and framework for mutual support, that we make other parts of the country aware of what we’ve done. We don’t have all the answers, but we’ve got some good stuff that we want to share as widely as possible.”

One exciting development currently in the pipeline for Matt and the Provider Collaborative is a

new medicines manufacturing centre, which will be built in Seaton Delaval. Requiring £30 million in capital, and scheduled to be making medicines by 2026, the centre had funding approved in July 2024. It will be the biggest of its kind in the country, representing a huge joint project for the Trusts, and creating 150 skilled jobs.

Alongside that, Matt and his team are developing new clinical and infrastructure strategies, and pushing on with digital opportunities, on which Matt says:

“Digital opportunities are enormous for us this year. Of course, we have the Great North Care Record, which has successfully brought the Trusts together, and now we’re looking to capitalise on the digital clinical systems that help staff work across different organisations.

Another area we’d really like to look at this year is working across primary and secondary care to make sure we’ve got good pathways in place, specifically between optometry, dental and GP colleagues. This is an area I can potentially envision us working with the Primary Care Collaborative on, exploring the sticking points within our pathways, how we improve them, and how we utilise collective resource.”

Collaborative work is about harnessing momentum, making and building on connections, and staying receptive to new thinking. Comparing the two Collaboratives’ work, Matt says:

“Although the Primary Care Collaborative has far more individual organisations to unite, and outputs will be very different, the core principle is the same. There are things that every organisation in a Collaborative will have to do, but that doesn’t mean they necessarily need to do them together, or that it would make sense for them to do so. And actually, that’s fine. What matters is that our aspirations remain immensely high. We’re setting an exceptionally high bar for our patients and communities. Being good isn’t good enough. Our collective action should drive us to delivering exceptional patient care and staff support. That’s my driver.”

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