Abstract
Health systems are now organized across England to deliver a more integrated population-based approach, not competing for services, rather collaborating and driving better value for the population from a fixed resource. This approach of health system leadership and collaboration has resulted in governance including a mixed economy of public-private provision but with greater alignment to delivering an agreed set of outcomes and value-based healthcare for the population. This dramatic shift from provider competition to collaboration and integration means a reframing of contracting and partnerships with the independent sector.
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