In line with “A Healthier Wales” the strategic programme for primary care (SPPC) confirms that “Working as a cluster ensures care is better developed and co-ordinated to promote the wellbeing of individuals and communities”.
This will require significantly enhanced professional engagement and leadership, very much aligned with the integrated planning approaches being developed across Wales. Health Boards (HBs) and Local Authorities (LAs), at a county level, should be able to commission services through a range of delivery vehicles, with all services and service providers (primary care, including general practice (GPs), dental, optometry and pharmacy, community nursing, mental health, charities, etc) being part of the solution.
An integrated service provides benefits for:
However, some flexibility is required here as one size does not fit all. 2022/2023 is a transition year so gives time for providers to consider and develop ideas around integration generally but in particular around the form, purpose, membership and governance of the delivery vehicle that will meet their vision for integrated working.
Cluster delivery vehicles are the entities through which services are delivered. These services are those that the pan cluster planning group (PCPG) decide are required to meet particular needs or are required across the whole cluster population. Cluster delivery vehicles might take the form of community interest companies (a social enterprise) or federations and provide entities that allow greater flexibility in areas such as recruitment which will enable collaborative working. These delivery vehicles could also provide a much more flexible approach to pooling of resources between partners to support integrated service delivery within the community.
Accordingly, this chapter will give providers an introduction to the choice of delivery vehicles available for this purpose, the factors that need to be considered in choosing and then structuring a delivery vehicle and the pathway to the establishment of one.