The Health Foundation analyses the benefits of intra-system partnering within the NHS

policy digest

07 / 11 / 2017

Partnerships for improvement: ingredients for success 
Health Foundation, October 2017

The Health Foundation has produced a briefing in conjunction with the University of Birmingham’s Health Service Management Centre. It attempts to summarise the main findings of the research report ‘Partnering for improvement: inter-organisational developments in the NHS’. The paper provides learning for NHS provider organisations and policy makers on what makes partnerships successful. 

The document recognises the importance of partnerships and partnering in national policy, with partnering seen as a central component of efforts to improve services. This was clearly espoused in the Five year forward view, which emphasised the need to move beyond organisational boundaries to improve services for patients. 

The research behind this report suggests that many different types of partnership can be applied in the NHS. They take many different shapes and forms with a range of ambitions, objectives and mechanisms to deliver improvements. A range of scopes, from small collaborations between individual clinicians to full structural, organisational integration, initiated voluntarily to pursue improvements or mandated by regulators. 

Ten to 12 people were interviewed at the site of each of the five case studies examined in this research. They included executive directors, senior managers, clinicians and support staff. The case studies included:

Voluntary partnering at individual levels, which the report notes can provide cost effective means to introduce new practices and enable mentoring. It also potentially drives entrepreneurial activities and can inject innovations. This type of voluntary partnering also allows those involved to tap into the intrinsic interests of those involved. Appropriate coordination and governance is needed to plan and periodically analyse impact. 

Structural partnering, is a type of partnering that the report says can facilitate more fundamental changes. The formality of a structural agreement allows partners to have greater confidence and therefore invest capacity and energy for increased impact. 
The report finds that ‘partnering can be successful between NHS and private organisations and can bring helpful diversity of resources, skills and networks’ 

Mandated partnering by regulators can make a positive contribution to the recovery of a struggling organisation, but it requires careful assessment of factors underlying poor performance. An example of mandated partnering at individual level included ‘buddying’ in an organisation under ‘special measures’. Green Bay NHS Trust was put in special measures by CQC and was buddied with Regency Vale NHS Trust as well as a US institute and consultancy firms.  Buddying was part of a combination of actions to improve, including replacing the board and overhauling the management. Buddying was seen to have contributed to improved performance in financial management and staff engagement. 

Key learning points 

  • Leading and managing partnering are different. 
  • Individual trusts will always be key 
  • Meaningful data is vital
  • The external environment can make or break partnering 
The report’s overall conclusion was that whilst partnering does have potential benefits, they are not quick or easy to achieve. To have an impact on care quality, the right form of partnering needs to be used in the right context, accompanied by the right set of enabling factors. 

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