Supporting NHS Trusts & Systems

As NHS Trusts work more closely with primary care and neighbourhood teams, success depends on understanding different organisational cultures, governance arrangements and ways of working. Approaches that work well in hospital settings do not always translate into primary care or PCN environments, making cultural insight essential to effective collaboration.

At Scale helps Trusts and Systems build a clear understanding of the primary care landscape. We provide tailored briefings for trust boards and transformation teams, offering insight into local structures, priorities and pressures. Drawing on practical experience, we explain how primary care decision-making works, what motivates GP-led teams, and how to engage in ways that build credibility and trust.

Our support includes stakeholder mapping, communications review and engagement strategy development, helping organisations move beyond transactional engagement towards genuine partnership. We also offer executive orientation, pre-engagement coaching and ongoing advisory support for neighbourhood transformation.

Many NHS Trusts are working to deliver more care closer to home. Achieving this shift successfully requires more than moving hospital pathways into community settings. Neighbourhood and primary care services operate with different resources, infrastructures and ways of working, and pathways need to be redesigned with these realities in mind.

At Scale supports Trusts and Systems to redesign pathways specifically for neighbourhood delivery. We bring trust and primary care clinicians together from the outset, assess readiness for change, and identify the resources, capabilities and governance needed to support safe transitions. Through structured clinical co-design workshops and practical planning, we help teams develop pathways that work in practice and are sustainable over time.

Our support includes three-to-six-month pathway redesign programmes, readiness and gap assessments, resource and capability mapping, and hands-on implementation support during service shifts.

As neighbourhood transformation programmes mature, trust boards, regulators and system partners need clear evidence that new models of care are delivering meaningful outcomes. Traditional acute-focused metrics do not always capture the full impact of place-based working, particularly where outcomes span trusts, primary care and community partners. Demonstrating progress requires evaluation approaches designed specifically for neighbourhood care.

At Scale supports Trusts and Systems to evidence neighbourhood impact in ways that are practical, credible and relevant to decision-makers. We work with teams to develop evaluation frameworks that reflect neighbourhood outcomes, design measures that cross organisational boundaries, and create tools for consistent data collection across partners. We also support clear, board-ready reporting and the development of regulatory narratives aligned to system expectations.

Our support includes evaluation framework design, ongoing impact assessment and reporting, board presentation support, programme reviews and regulatory narrative development.

Effective neighbourhood working depends on strong relationships between Trusts and Primary Care. While formal agreements remain important, lasting collaboration is built on shared purpose, mutual understanding and meaningful involvement in decision-making.

At Scale works with Trusts and primary care providers to develop partnerships that go beyond contractual requirements. We help organisations strengthen relationships, align priorities and design governance arrangements that enable shared ownership and collective decision-making. Our approach focuses on building trust, supporting constructive dialogue and creating the conditions for collaboration to succeed over the long term.

Our support includes partnership development, relationship-building and facilitation workshops, governance framework design, and advice on fair approaches to resource sharing. We also support business case development, funding applications and joint venture proposals for neighbourhood health investment, alongside frameworks to track return on investment and partnership health.