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Keep looking to the horizon: how to keep steering the partnership in stormy waters

Do not look to the ground for your next step; greatness lies with those who look to the horizon – Norwegian Proverb.

Claire Oatway

I recall conference season in Autumn 2019 and many sessions were jammed full of hope and ambition for partnership working. That seems a very long time ago for many parts of the country and health and care have been placed under enormous pressure. These unprecedented times have brought about positive change in terms of leaps in technology, process change and unwavering compassion for those in need. Whilst there are still signs of positivity there’s still an undercurrent of overwhelm and reactiveness that pervades many conversations.

Over my career, I’ve worked in a number of different settings supporting partnerships. Often, mixed public-private partnerships and often at a metropolitan scale. What I’ve consistently witnessed is that alliances are easy when they are safe, funded and unaccountable. Conversely, it’s at times of crisis that its just as easy for partnerships to fail. Its not a mark of the personal commitment of leaders around the table or indeed a mark of long term strategic intent.

There have been many reasons for partnership failure – a lack of direction, trust, momentum, clarity are all conceptual reasons for failure. Partnerships can suffer at external shocks – poor inspection outcomes, withdrawal of funding, changes in national policy. Sometimes, for individuals there’s simply a conflict between the demands of a partnership and the demands of their employing organisation. Partnerships are not an altruistic activity but they do demand full commitment to thrive and executives are judged more on the success of their own organisation than of a partnership they led.

What practical steps can you take as lead to shore up your partnership – whether as part of a Primary Care Network or as an Integrated Care System?

  1. Agree that you have more in common than in difference. This is a time of great uncertainty when leaders will naturally tilt towards their own organisations but it is a time when it is vital to keep looking out. No provider works in isolation and failure in any part of a system can damage another. As a leader, keep considering the impact on other areas, keep as flexible as you can about resources and whether you can share resources differently to prevent failure
  2. Keep looking to outcomes not outputs. Of course, there are targets and specifications but at the heart of national policy is a drive to deliver the quadruple aim. It takes courage for commissioners and providers to hold that space but the time before the pandemic was still a time for poor health outcomes, inequalities, workforce gaps. The urgent – important concepts of time management highlight how important it is not to let the crisis create a narrow view of the job to be done
  3. Partnerships depend on trust. Irrespective of which sector you’re in, partnerships fail because of trust issues, when a series of behaviours or disagreements begin to erode goodwill. The opposite is also true – behaviours which enhance communication and trust will reinforce partnership behaviour in years to come. Some posts, such as network managers, are designed to work across organisations and are invaluable in identifying areas of collaboration
  4. Stay curious and inquisitive. If things go wrong be careful not to play the blame game. Take a dispassionate view of events that led up to any failings and make extra allowances for the stress within the system which heightens everyone’s sensitivity to criticism.
  5. Remember its not about today nor is it about your organisation. Partnerships are rarely formed for very short term action and in our systems they are formed with communities in mind. Keeping language framed around community needs is helpful in avoiding professional or organisational hierarchy.

Successful teams and successful partnerships should bring rewards greater than the sum of the parts but they do require input and energy to thrive. As well as the rewards they reap across a community, partnership working can also be fulfilling for members bringing creativity, support and challenge. If you’re interested in exploring this topic further, PCC offers a range of professional development opportunities including group facilitation that can help your partnership to realise its ambitions.

Claire Oatway, is an independent coach and consultant. She has an established reputation for leadership and management and a passion for partnership working and positive disruption. She has influenced national policy on primary care networks and multi-disciplinary working and is a Governing Board Member of PCC.