Essex Partnership University Trust is a mental health and community healthcare provider covering a population of more than 2 million people across Essex, Sussex, Hertfordshire and Bedfordshire. The organisation operates in a highly complex local healthcare system, with 7 Clinical Commissioning Groups, 3 upper tier local authorities, 12 district councils and 3 Integrated Care Systems. The way the NHS is funded and does business was about to dramatically change and the Trust wanted to develop a modern strategy for both its commercial relationships and local partnerships, while putting patients at the centre of everything it does.
The Trust had been successful at winning contracts on a competitive tender basis. While it had experienced some challenges, it had also won new business including Immunisation Services across multiple geographies and Improving Access to Psychological Therapies. However, the organisation faced increasing competition from both private providers and other NHS providers from out-of-area. The Trust Board was concerned that they were losing market share and were no longer perceived as the provider of choice for local services.
They also recognised that the future commercial environment would be more complex and more nuanced than those of the past, with Integrated Care Systems bringing commissioners (in both the NHS and local government) and providers closer together and asking them to take shared accountability for population health outcomes.
The Trust Board asked us to help them develop a modern commercial strategy that was fit for the new commissioning and operating environment of the NHS. This was to make the most of the existing successes and commercial capabilities in the organisation, while enhancing the focus on local partnerships and becoming the provider of choice for mental health and community services.
We began by speaking to stakeholders across the organisation to understand the Trust’s existing commercial strategy and how this was perceived and understood by people in different roles. The project began at the onset of COVID-19 so, to mitigate the pressure on clinical and operational staff, we undertook this work in two parts. We first engaged with the Executive Team, Non-Executive Directors and staff in corporate roles to understand the corporate view of the strategy. Once pressures on frontline staff had begun to ease, we then engaged with the medical, nursing and operational teams to learn how they interpreted the strategy and its relevance to their roles.
At the same time, we undertook a detailed analysis of the local healthcare market. This included developing a clear picture of an incredibly complex and fragmented local commissioning landscape, with services commissioned by seven CCGs, three local authorities and NHS England. We analysed contracts registers and commissioning forward plans for all of these organisations and built up a comprehensive picture of how services were provided. This allowed us to produce a strategic forward plan for the Trust, based on local commissioning intentions and contract expiration dates, supported by detailed competitor analysis of incumbent providers, identifying their strengths and weaknesses and how the Trust should position itself to regain market share for each service in each local area.
We also looked at the national picture, assessing both the existing policy context and political direction of travel for the NHS. This led us to recommend to the Trust that it reframe its commercial strategy as a commercial and partnerships strategy, which would best position it as the provider of choice in an Integrated Care System model.
A clear strategy with buy-in from across the organisation. The Trust Board previously had different ideas about what it means to be commercial in the NHS; the new strategy helped to unify the board around a shared vision to work towards together.
A strategic forward plan of commercial opportunities, built from a comprehensive picture of local commissioning intentions and contract arrangements. This has allowed the Trust to plan for upcoming opportunities and better mobilise its resources to develop compelling and innovative proposals.
Enhanced market insight, including an understanding of the strengths and weaknesses of competitors. This will help the Trust to balance quality, price and innovation in future tenders in a way that meets commissioners’ requirements, beats competitors and regains market share.
Opportunities Qualification Process – a more systematic approach to assessing the commercial viability of contracts and qualifying these opportunities to ensure the organisation is focused on services where it can provide value and deliver within budget.
A new capabilities framework, identifying the knowledge, skills and resources the Trust will need going forward to maximise the opportunities that exist locally and nationally. This is supported by a plan for a ‘commercial culture’ that is aligned to the organisation’s other change initiatives and culture roadmap.
Human Engine is a Financial Times top-ranked management consultancy with specialisms in strategy, people and performance.
It was founded by a group of former local government officers who think the public sector deserves better than it gets from traditional consulting firms – more human, more personal and more knowledgeable of the reality of delivering modern public services.
We have worked with dozens of public sector organisations to help transform their strategies, operations and cultures to be more agile, commercial and entrepreneurial in order to achieve financial sustainability and improved outcomes for local people and communities.
We are currently writing our latest report, The Commercial Edge, in partnership with leading think tank Localis, making the case for entrepreneurialism in public services and local investment as a catalyst for economic recovery and growth.