Will the consortium be dominated by the big players?

No.  On the contrary, it will be essential to involve smaller organisations in all aspects of the consortium and its work, including having small associate members as board members/trustees.  As a large scale umbrella structure the consortium will need to develop the local market of voluntary sector suppliers (including small, niche providers) on a continuous basis, otherwise it might be accused of being a closed circle of collaborators (monopoly) and this would be detrimental to its chances of winning contracts.

Also, because of aggregation (lots of smaller contracts being bundled up into one large contract), there will be a tendency for the resultant contract frameworks to be broad ranging or holistic in scope.  This will require larger providers to work with smaller, niche providers in order to ensure full coverage of all service requirements.  This is likely to be accentuated by the drive towards demand/patient led commissioning/personalisation, which focuses on ‘whole person’ needs.