Seeking the approaches that enable faster change in the complex world of health and social care
Effective Partnerships are incredible, but they can also be incredibly frustrating. The current set of STPs (Sustainability and Transformation Partnerships) in English healthcare are an excellent example, with a prevalence of both effective and frustrating partnerships.
Increasingly, organisations are working in partnership with other organisations. In healthcare, this is inevitable due to the hugely complex interdependencies between services and organisations whatever their structure. However, effective partnerships are hard, really hard.
I’ve worked in lots of multi-organisation partnerships, and my experience is that they can be very effective at making positive changes, but sometimes they can be very tokenistic, consuming their own smoke and achieving little. An essential element is that partnerships need time to mature and this can be very frustrating in a world that demands rapid results. This frustration then leads people and organisations seeking a ‘Silver Bullet’ to bypass the maturity process or accelerate it, often having the opposite effect.
Although it may seem quite old, the observations of Moss & Kanter (1985) resonate with my experience of partnerships. They highlight the importance of trust in partnership relationships, this matches my own experiences. Within organisations hierarchy appears to trump Trust, evidenced by the experience of many untrustworthy and morally misaligned people working in senior positions as ‘successful’ leaders, using their hierarchical power to drive change. However, in partnerships, as ‘no one has hierarchical power over another party’ the need for trust in key relationships is paramount for progress. My experience is that time spent in creating and coaching for this, isn’t time wasted, although it is often perceived as such. Moss & Kanter go on to advise how organisations and their key staff can achieve effective partnership, as follows:
This is excellent advice as partnerships quickly become superficial without attending to these. Accelerating change in partnerships can often struggle as partners become suspicious of intentions, responding by seeking to control or take a passive role in the partnership, impacting negatively on change initiatives. I’m not sure what the partnership attrition rate is, but I’m guessing it is very high. Even partnerships which achieve trust early have to be attentive to maintaining mature open collaborative communication to sustain the benefits, they also have to carefully manage any changes to key personnel.
From my own experiences, I’d add one further area of advice, the importance of having a coordinator role, an independent focused on the partnership vision, with no allegiance to any party. They are able to challenge and support key people, helping guide them toward a collective position and set of trusting relationships. This role, above all others, needs to be a careful appointment with involvement from all parties. It is a role that is crucial in the early stages, but it is required throughout the partnership.
Partnerships are worth fighting to create and maintain, they give organisations access to a broader set of capabilities, cultures and assets, allowing them to tackle more complex problems holistically.