New Report on ‘Alliance Contracting’

New Report argues ‘alliance contracting’ between the NHS and the third sector can  integrate health and social care, and overcome ‘bureaucracy that harms people’

A new report published today by the Association of Chief Executives of Voluntary Organisations (ACEVO) argues ‘alliance contracting’ between the third sector and the public sector in health and social care is necessary if future NHS crises are to be avoided. The report is sponsored by leading healthcare and charity lawyers Hempsons Solicitors, who also provided expert advice on its contents.

‘Alliance Contracting: Building New Collaborations to Deliver Better Healthcare’ involves the NHS working directly with groups of third sector organisations before the contract is put out to tender, so as to most effectively involve charities and social enterprises in the design of the intervention.

The report is launched at ACEVO’s flagship annual third sector Health and Social Care Conference, where speakers including Jeremy Hunt and Andy Burnham will set out their parties’ pitches to the third sector.

The ACEVO report calls for ‘collaborative approaches’ to replace competition as the dominant commissioning model for ‘relationship based’ services.

The report sets out practical steps for alliance contracting to be put in place. It calls for:

  • Political parties to commit to putting alliance contracts in place in health and care during the next parliament
  • Political parties to ensure commissioners can deploy alliance contracts as a genuine alternative to traditional contracts.
  • A Collaborative Commissioning Unit to be set up in government, to examine how alliance contracting can be used in such a way that it develops existing engagement with the third sector.
  • NHS and Monitor to ensure health-specific legislation supports sustainable alliance contracting
  • New government procurement rules to take into account EU criteria which allow the awarding of contracts based on social, environmental and innovative characteristics. 

ACEVO’s report is published in response to the NHS’s acknowledgement of its need to deliver integrated care and more joined up working with the third sector. The report builds on ACEVO’s longstanding work in developing third sector consortia, groups of charities and social enterprises that come together to share strategy and deliver services. In October last year, ACEVO published Real Local Change, which demonstrated how these new models can work, and transform the quality of service people receive.

Commenting on the report, ACEVO’s CEO, Sir Stephen Bubb said:

“The NHS Five Year Forward View made it clear that the NHS needs an even stronger focus on preventive and integrated care. This demands innovation. Whether it is through helping people with learning disabilities or keeping people out of accident and emergency, all too often big bureaucratic contracts are harming people and preventing them from getting the community services they need.

“In the past I’ve argued for competition as the best way to deliver high-quality integrated care for patients. Today’s report shows how to make alliance contracts a reality. They are an efficient way for health and care commissioners to bring in a wide range of service providers in to work for their service users by collaboration, not competition. They avoid the risk of bureaucracy that harms people.

“We need to move beyond competition and think more radically about how we deliver the healthcare we need. In the weeks before the election the political parties should seize the initiative on alliance contracting and make clear their commitment to it.”


For media enquiries please contact George Bangham or 07825 894716.

 A PDF copy of the ACEVO report is available here:

Alliance Contracting Report

Alliance Contracting – web version

Alliance Contracting – print-friendly version





1. ACEVO is the Association of Chief Executives of Voluntary Organisations. We support, connect and represent the leaders of the UK’s 1,500 largest charities and social enterprises. More information at

2. There is strong political consensus in favour of integrated care and alliance contracting. On 27 January 2015 Andy Burnham spoke of Labour’s plans for alliance contracting, saying “we will move away from an approach based on short-term contracts towards long-term alliance contracts as proposed by the Oldham Commission”. See

3. ACEVO CEO Sir Stephen Bubb led  the work of the ‘Choice and Competition’ workstream during the Government’s 2011 ‘listening exercise’ which contributed to the development of the Health and Social Care Act 2012.

4. In recent weeks ACEVO has argued that the third sector needs to be brought into the debate on health and care integration. ACEVO convened a £1.5m programme to enable third sector organisations to help accident and emergency units during the winter crisis, and Sir Stephen Bubb chaired an inquiry into the delivery of the Winterbourne View promise, which argued for the closing down of institutions for people with learning disabilities and/or autism and the enhancement of community care. ACEVO CEO Sir Stephen Bubb recently wrote in the New Statesman supporting cross-partisan moves for better health and care integration.

5. More detail on alliance contracting and its origins: In an alliance contract, service providers come together under the same contract and all have an equal decision-making role and responsibility for risk and reward – even if they deliver separate parts of the work. First developed for North Sea oil platforms in the 1990s, alliance contracts are designed to speed up the contracting process and avoid the problems associated with long supply chains and multiple layers of subcontracts. Despite the political consensus over the need for further health and care integration, commissioners still lack the means to achieve it. ACEVO’s report draws on third sector leaders’ experience at the front line of health and care, and proposes methods to make alliance contracting a reality.


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