Abstract

A new era is dawning in the commissioning and provision of primary health care. The visionaries promote greater integration of care, encourage creative contracting, and above all inspire collaboration across providers to achieve best patient care. This will give rise to a new style of provider partnerships. Where does this leave end of life care in the voluntary sector? It is vital that the passion and independence of what we do is sustained throughout the maelstrom of oncoming change but equally important that we contribute, collaborate and continue to lead and provide best practice end of life care no matter how the contractual landscape might change.

This paper will address some key contractual issues for consideration by the voluntary sector when seeking to be involved in the new-style provider partnerships. It will cover legal aspects of confidentiality agreements, exclusivity arrangements, sub-contracts and the operation of TUPE. Whilst the collaborative approach is characterised by shared accountability and a high level of inter-organisational trust, as in other sectors this can often translate into robust traditional-style contractual regimes at odds with those core values on which the partnership is founded.

This paper considers these aspects from the voluntary provider perspective. It reflects our experience as transferee in a TUPE transfer of end of life services from a private provider to us as independent hospice and explains how that has informed our thinking going forward. To conclude we shall propose guiding principles to underpin a form of collaboration agreement pursuant to which the Hospice provider may work alongside the new-style provider partnerships to ensure appropriate delivery of valuable support of the partnerships’ desired end of life outcomes.