Collaboration is not for control freaks | Dr Charlotte Augst

Charlotte Augst

Somerset Sustainability and Transformation Partnership has been collaborating with the Richmond Group of Charities and wider voluntary sector on a programme called ‘Doing the Right Thing’. Charlotte Augst shares what she’s learned so far about collaboration and leadership.

Organisations are designed so that people at all levels know what their job is in relation to the organisation’s mission. The clearer the strategic focus, the better.

But if collaborations are to work, people need to be able to see the world from outside their organisation. That way, they understand that the point of social care is not to stop people going to hospital. Or that the point of primary care is not to read consultants’ letters.

People working in collaborations need to be empowered to step outside of a narrowly defined understanding of what ‘their job’ is. For instance, if your collaboration partner doesn’t like a word you keep using in your communications, you need to be able to say: “Okay, what word works better for you? Shall we change it?”.

But what does this mean for leadership? You need to be sure the person charged with collaborating understands the point of their work and gets the importance of making things happen. And that way, you can empower them to make the decisions required. In a way, you need them to become less accountable to you and more accountable to the person they are trying to collaborate with.

Doesn’t sound like how healthcare is currently led and organised? Well, indeed. And in my view, that is one of the reasons why so much good will and genuine enthusiasm for collaboration dissipates before demonstrable results are achieved.

Imagine this: we agreed with Somerset STP that we would start a practical collaboration to explore how everything the voluntary sector has to offer could be brought to bear on the health and care challenges in that place. We didn’t set up an elaborate reporting structure the programme team would need to keep feeding. And we didn’t create a central team to supposedly ‘support’ programme colleagues on the ground, but which then ends up asking for endless submissions of slide decks, theories of change and progress reports.

We actually asked our programme lead what they would find useful by way of support. Not surprisingly, they opted for a weekly phone call, where they could chew over the many conversations they had during the previous week. Mostly, we simply agreed with their judgement. On occasions, when the lead was genuinely unsure, we weighed up what we had learned so far with what was at stake and resolved the matter then and there. As far as I am aware, at no point during this first year of our collaboration were things on hold because we needed to get a decision out of the Richmond Group.

Of course, there were formal decision-making points, where we needed to review and agree the general direction and next steps. But with all the questions about wording, sequencing, relationships and local priorities, we simply supported our programme lead to reach her own judgements.

It is this flexibility and bottom-up decision-making that in my view has enabled us to make any progress against the backdrop of near constant reviews of processes and governance on the statutory side.

This is not to say there are no good people or there is no good work going on in statutory change programmes, but it seems to me that this work happens despite all the obstacles of process, rather than on the basis of trusting, empowering leadership.

It turns out, collaboration is not for control freaks.

Dr Charlotte Augst is partnerships director at the Richmond Group of Charities. Follow her on Twitter @CharlotteAugst

Dr Michael Bainbridge, head of primary care at Somerset CCG, has shared the STP view of collaboration in an article for the Health Services Journal.

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