Creating a Collaborative NHS

Published by Mike Holmes


The NHS is in the grips of a winter crisis, the “worst winter yet” according to many reports. As acute trusts cancel routine surgery and struggle to cope with rising demand for beds and ambulance services, general practice is under mounting pressure to keep patients out of hospital while managing an ever increasing workload.

It is a critical time for our patients, and for us – the people working at the frontline. Burnout is an all too real consequence of growing workloads and insufficient support. There is mounting evidence of doctors seeking support through the NHS Practitioner Health Programme, with research suggesting that up to three GPs a day are seeking help for burnout or stress.

Flu may be dominating the headlines, but it is the demands of an ageing and increasingly complex patient population, combined with a chronically underfunded system, that is underlying the current crisis. While financial investment is necessary – and very welcome – it is not the only answer. Challenges in recruiting and retaining staff are evident across the whole health sector. In general practice, the government’s target of recruiting 5,000 new doctors by 2020 seems increasingly difficult to achieve.

The solution is clearly complex, but part of this would be a truly collaborative health and social care service – one which provides high-quality, joined-up care across the whole system – ensuring we can all focus on patient-centred care. This would not only give patients access to the best care possible, it would also help us to use resources more effectively and efficiently. Working together we can educate patients to navigate the system in the best way possible. Campaigns such as the RCGP’s 3 before GP is a really good example of this.

Many groups, including NHS Collaborate, are already helping to bridge the divides of a fragmented system. We are creating a specific space for primary care leaders to initially connect across professional, organisational and geographical boundaries. We are laying the foundations for a future of collaborative, compassionate care across the whole health and social care system.

The expansion of Jeremy Hunt’s role to include health and social care feels like exactly the right thing to do, but that alone is unlikely to be enough. We must all hold the government to account to deliver the pledges they have made. Using a collaborative approach, we can move towards a unified system that enables us to do just that, while achieving sustainability for us and providing better quality care for our patients. The challenges we face are clearly complex, but collaborating both within and across the health and social care sectors seems like the right path to take.


Dr Mike Holmes is a GP and co-founder of NHS Collaborate. He was recently elected vice chair (membership) of the RCGP.

Follow him on Twitter @holmesfest