Lead Provider MSK Pathway
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Lead Provider MSK Pathway

We were instructed to advise a GP Federation in respect of their role both as lead provider and part of a collaboration of a range of providers to provide an integrated, multi-disciplinary musculoskeletal ("MSK") service.

The collaboration involved an NHS Trust, an NHS Foundation Trust, a third sector organisation and a newly formed corporate joint venture. Each of the participants held a different role in contributing to the delivery of integrated MSK services. 

Key features

  • The GP Federation agreed to hold the head contract with the Commissioners on behalf of the MSK Partnership. It sub-contracted various obligations to its partners in the collaboration and entered into support services agreements with certain partners
  • The collaboration involved various organisations with different governance structures and different commercial interests, but all focussed on seeking to integrate care, to deliver care beyond organisational boundaries, and to create single teams with shared purpose, single management structures and single performance frameworks
  • The project itself required the design of the contractual structure between the various collaborating providers and sub-contractors, consideration of the governance arrangements for the consortium, negotiation of the head contract with the Commissioners, as well as putting in place a contract in relation to the role of treasury management and working capital with one of the partners in the collaboration

Overcoming the challenges

One of the key challenges in a collaboration of this nature is clearly specifying:

  • Each partner's role and responsibilities in the collaboration;
  • What risk and reward each party is willing to accept for participating in the collaboration;
  • How the partners will collaboratively make decisions and resolve disputes;
  • How the partners will deal with matters on termination or exit of the arrangements, in a situation where one partner leaves, or indeed when the whole collaboration is being wound up.

It was also important for the partners to clearly demonstrate to the commissioners the robustness of the contracting arrangements between the partners, to satisfy the commissioner's own due diligence commissioning the services from a network of partners.

For further information on the related models of care:

Multi-speciality Community Providers