National Leading Improvement for Health & Well-being Programme Making partnership working effective

1. National Leading Improvement for Health & Well-being Programme Making partnership working effective Robin Douglas 2011

2. In it together ?

3. Mistakes we all can make • All partnerships are the same • Organisations lead partnerships • ‘A partnership is not just for Christmas’ • Leaders lead partnerships • We need lots of meetings • We have to plan and do things together • It is important to involve everybody • ... and it’s just about partnerships, not partnership working

4. Not just partnerships - there are three modes of organisational working • When organisations are in competition • Through co-ordinated but independent approaches • In co-operation or partnership

5. Choosing an approach • You promote competition when? • Develop co-ordinated approaches when? • Promote co-operation or partnershpwhen?

6. Degrees of partnership

7. What do we know about partnership working? • Research and evidence is weak • Working across organisations is crucial to effective outcomes • Learning is mostly from hindsight • There are some key enabling factors • Leadership is a key • Clear purpose and achievements is another • From your experience of partnerships and partnership working, what do you know?

8. Writers about partnerships • Rosabeth Moss-Kanter – 6 characteristics of success • Huxham & Brodie - Potential for Partnerships • Miller – successful community based alliances • Powell - 7 dimensions of healthy alliances • Hunter – effective partnership working in health

9. Key features for closer partnership working • Recognition of task dependency – ‘we need each other’ • Cultural understanding and acceptance – ‘we understand each other’ • Consensus about ends and means- ‘we agree about what we are trying to achieve’

10. Mutual awareness – we are aware of the issues and pressures we each face’ • Experience of collaboration, resource exchange – ‘we have a history of partnership that we can build upon’ • Geographical coherence – ‘we are part of the same Place’

11. Partnerships - 3 areas for learning from recent Total Place activities • About leadership • The processes of partnership working • People in partnerships

12. Leadership in partnerships: • Leaders provide space, encouragement and support - not solutions • Leaders will be required to change, there is no easy option • Leaders in partnerships are not necessarily the ‘bosses’ • The influence of leadership is crucial, and is complex: • Positional • Knowledge and understanding • Personal • Networked

13. Leading with different sources of authority Given Positional Wisdom Based on Role & Organisational Position Based on the Belief & Trust of Others Earned Knowledge Based on Personal Capacity Experience & Understanding Acquired

14. Process and partnership working: • Working and thinking together is learning – people don’t start from the same place • Think and act with systems not organisations • Working and building partnerships is messy and uncertain • Purpose and outcomes should lead process - not vice versa • The process needs to be – • Convergent and divergent • Open and led • Planned and emergent

15. People in partnerships: • Listen to real people – it’s about their experiences and voices • It’s about your people and places, not just organisations • From formalPartnerships to professional friendships and joined up leadership • The Pilots provided people to help, challenge, shape and enable the processes locally • It costs in terms of time, energy, commitment and influence – but for many it is worth it for more real and effective partnerships with improved outcomes and some efficiencies

16. Who’s outcomes?Understanding Needs: Jonathan Bradshaw

17. Policies and partnership: what are the implications of the following - • A big society? • Fair Society, Healthy Lives – Marmot? • Liberating the NHS? • The spending review ? • Personalised services? – for adults and children/families • Community budgets?

18. Leading in partnership requires a… • Focus on outcomes… there are often different ways of getting there • Focus on strategic behaviour, not just ‘strategies’ • Recognition that a plan is not a strategy • Understanding that single or simple solutions rarely work, consider systems and connections

19. When is it leadership ? CommandManagement Leadership • Focus TacticalOperationalStrategic • Time Short TermMedium Term Long Term • Problem Critical Experienced New

20. Sustaining partnerships needs some enabling features: • Clear leadership and common purpose – a focus on outcomes • Shared understanding of each others values and priorities • Real achievements to celebrate • Commitment, energy and support from participating organisations/people • Shared, trusted information and flexible systems

21. and • Effective and open communications • A recognition of the real pressures facing members • An explicit and accepted position on resources • Orientation to and space for shared learning • Positive focus on the history between partners

22. Mapping your partnership working action Tensions Conflicting priorities Turf wars Service focus Integrated activity Flexible use of staff Rule breaking Tensions in governance Outcomes focus mode agency Complex accountabilities Façade activities Large scale meetings Expressive focus Networking Cultural development Relationship building Governance focus collective orientation planning

23. Auditing your partnership activity • Where is your partnership on the diagram? • Where do you want it to be? • What would help make the shift? • What help might you need to change things?

24. Reviewing your partnership experiences • Where has working in partnership benefitted your local people? • Where are the greatest inefficiencies in your partnership? • How can you build improvement into your partnership? • What two things would improve your partnership working?