Before any work is undertaken it is helpful to think through the reasons for forming an alliance model.  It is also useful to ensure there is sufficient interest.  The concept should be discussed informally with other provider and stakeholder colleagues to ensure that the work involved in planning is supported. It is useful to consider whether:

• the specialty is well-defined.
• the specialty has defined quality metrics or standards, not necessarily with consistent national performance.
• the specialty providers have shared concerns that would benefit from national collaboration; these could include funding, resourcing, efficiency or workforce.
• interested clinicians, managers and executives will want to get involved.
• the specialty providers and stakeholders are willing to work together.
• existing work is being led on quality improvement by other organisations, for example professional colleges.
• a more focused alliance (in geography or ambition) is workable if a full alliance is not possible.

Before establishing the UKOA, the clinical lead for the Moorfields’ vanguard programme contacted a number of providers and stakeholders to gauge interest. This indicated sufficient interest to warrant an inaugural meeting.