Partnership – why so difficult?

The news that one STP area is struggling with Board behaviour to such an extent that they’ve had to ban certain behaviours may be greeted with a wry smile by anyone in the NHS – or amongst its partners – who can picture the scene and recognise the mindset?

shallow focus photography of five people holding each other hands
Photo by rawpixel.com on Pexels.com

The image of a dysfunctional STP leadership team playing out their mutual suspicions inside and outside the boardroom should serve as a warning. The NHS is about to celebrate its 70thbirthday. Yet many of the local organisations that comprise the NHS are still taking baby steps and like all toddlers, they run around a lot, get bored easily and have the occasional tantrum.

But why should anyone be surprised? Positive partnership behaviours demand shared vision, an honest appraisal of your own strengths and weaknesses, anticipation of trouble ahead, and a big dollop of empathy: not qualities we always associate with leaders in any walk of life.

The demand for integration, driven by the belated realisation that nothing harms patient care more than a fractured NHS which pits clinicians, managers and organisations against one another, will not go away. Simon Stevens wants a rocket launcher placed under integration. An apparently more measured (or, depending on your viewpoint, less ambitious) Health Secretary wants complete integration of health and social care within 10 years.

One STP leader locally sat in my office a couple of years ago and described, not as a health professional but as a carer, his vision of a single coherent team of different professionals from different organisations offering wraparound support to patients and carers. For too long we have asked patients with complex needs (i.e. most) to manage the complexities of a fractured health and social care system themselves. Managing teams across different organisations is our job as leaders, it should not fall to patients or carers.

In our work at The Wellbeing Collective, we see some NHS leaders who have grasped the vision and ‘hold hope’ for STP’s or accountable care systems to explicitly value and embody the kind of partnership behaviours that should be intrinsic to modern leadership in the NHS and beyond. This type of integration includes not just the world of social care, but the 3rdsector and patients and carers in their partnership thinking too! That’s the sort of sustainable transformation we’re interested in seeing and would make the ‘NHS at 70’ celebrations something to really get even more excited about.

Richard Barritt – Consultant, The Wellbeing Collective.

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