Collaboration is one of the words we are hearing most often as integrated care systems are starting to take shape. But how can you help this to happen? One of the themes in the Long Term Plan and strengthened by the White Paper is that organisations should work across the system – not just considering their own targets or financial position, but those of the system. To start with – who to collaborate with? Although the White Paper outlines who should be on the boards, for practical collaboration to improve the health and care of the population there is a need to collaborate at the right level, with the right partners for the changes being considered. This won’t always be the same group of people and organisations. For some areas this may be at ICS level, but more likely to be at place or PCN level. Involving health partners (Trusts, PCNs, GP practices, community services including other primary care services) local authorities, patients, voluntary, community and social enterprise partners and community groups will be important depending on the area being considered. To successfully collaborate and keep the relevant partners on board win-win solutions will be needed – but how to get there?
Stephen Covey, in the seven habits of highly effective people, recognised that valuing differences is the essence of synergy, but to get there you need to thoroughly understand others so that you can then present your ideas contextually based on others concerns. So seek first to understand others. We usually listen with our own frame of reference in mind – so we evaluate what others say – agreeing and disagreeing based on our beliefs, we may question or probe – based on our frame of reference, we advise, based on our experience and interpret, based on our understanding of the world. Suspend judgement – and really listen, check your understanding of what others are saying; build trust by understanding their world and their concerns. Probe to find how they feel about the situation and express understanding of their perspective. Use active listening with open questions.
- Give people your full attention
- Give messages that you are listening
- Be ready to paraphrase or ‘play back’
- If you do not understand – ask
- Acknowledge the other person’s feelings
- Encourage the other person if they appear uncertain
- Do not respond until the other person has finished
- Beware of passing judgement too quickly
How this can be done can include reframing and checking your understanding of the situation – then seek to jointly find alternatives and solutions, with an open mind. Find a shared purpose and work through why is this important. When you work through a solution with others, explore why you are doing it this way, what is the problem being solved. Work through a story of what the future looks like that you can share and use to communicate to others who will be involved in implementation. What will be the call to action – why does this need doing and what shared problem will this solve?
Start by listening, gaining trust and genuinely working through a shared solution. Addressing others concerns will gain the trust and co-operation needed to move from defensive – win/lose solutions to shift to the win/win changes that are needed to develop care for the future across systems, at place or primary care network level.
So seek first to understand, listen without imposing your own frame of reference and beliefs, check your understanding with other parties and jointly consider all the alternatives. Only then agree the clear desired outcome, the shared story of what the future will look like making sure all parties are happy with this vision. Then work back as to who needs to do what, the call to action for each team, clearly articulating the problem this will solve – and plan steps to make real changes together to improve care for your population.
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