Why the shift to community needs sound governance

a senior advisor for neighbourhood health is a signal that the government is serious about shifting care into the community as a key element of its 10-Year Health Plan.

broadly about bringing together teams of clinicians to provide seamless services for people in their homes and communities. But the organisations running those very local services usually operate on a larger scale. Therefore it is critical to find workable models that support collaboration between providers – primary care, community, mental health and acute providers, local government and others – at "place".

maturing in many areas, but how to strengthen and build on them is a key question for the 10 Year Health Plan working group on accountability and oversight. Various models have been suggested, such as the revival of 'accountable care organisations', which could see a single body managing all services, or lead provider contracting, which bring multiple partners together under a single contract held by one organisation. NHS England has already signalled that, as part of a shift toward "strategic commissioning", providers may "deliver commissioning directly through delegation arrangement or provider collaboratives". deliver commissioning directly through delegation arrangement or provider collaboratives".

It's encouraging

to see efforts are underway to break down the barriers to joined-up care. Trusts will play a key role in this transformation. However, success will depend on strong governance and using tried and tested approaches to bring different sectors together.

Strong governance

is vital to enable responsibilities to be held at a local level, to manage large taxpayer-funded budgets, and to take decisions to improve services and bring them together.   Robust governance structures are also needed to make it clear who is responsible for services, and to enable them to be held accountable to the public, partners, and government.