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NHSE to revive 2000s-style improvement collaboratives

NHS England plans to revive compulsory “structured improvement collaboratives” for outpatients, urgent and emergency care, and frailty services – in an echo of the Modernisation Agency approach of the 2000s.

The three collaboratives will be on a compulsory basis “to improve care at scale across the NHS”.

The approach is explicitly modelled on the “emergency services collaborative”  run by the NHS Modernisation Agency between 2002 and 2005. It played a big part in driving services towards meeting the new four-hour accident and emergency target, according to a 2004 evaluation.

A paper presented to NHSE’s board this week set out a wider reset of NHSE’s improvement framework, making clear responsibility is firmly with providers, while the centre focuses on “creating the conditions”, regional teams “support”, including with strengthened “local improvement networks”. Integrated care boards will focus on commissioning.

But the proposals – developed by Sarah-Jane Marsh, national director of urgent and emergency care and operations, and Glen Burley, financial reset and accountability director – said a “small number of national priorities will require a systematic ‘all-in’ effort to improve care at scale across the NHS”.

These will be targeted at specific changes in the three priority areas, with improvement experts and clinicians facilitating sessions where teams share best practice and improvements.

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Source: HSJ, 7 February 2026

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