Consider the purposes and costs of partnerships – working together may not be for the better, says Robin Miller
Partnerships are hard to escape if you work in health services. They have been developed at all levels from strategic to frontline and have ranged from long-term formal agreements to looser arrangements for short-term projects.
Incorporating two or more agencies, they often involve other public sector bodies, patient and community groups, as well as private businesses and the third sector.
The general expectation is partnerships make it easier for people to access services, while eradicating duplication.
Pooling expertise and/or resources will lead to long-standing, complex issues such as health inequalities and the abuse of vulnerable people being addressed.
It is hard to argue against the logic of partnerships. Common sense tells us care will be better if the health service works with social care, police and housing services.
But the case for partnerships is less certain than one may think. Evaluations are often focused on the development of the partnership and relationships between agencies, with patient outcomes less well explored.
A causal link between a partnership and an outcome is often hard to establish. Evaluations can be complex and resources do not permit sufficient depth. Many factors can be involved and it can take time for these to be analysed – by which time the partnership may have changed.
This does not mean that partnerships are less effective than single agency working, but they do incur greater costs. These can be in the form of the time it takes to agree, implement and administer, and in the case of more formal arrangements in meeting legal and governance requirements.
Five tips for working in partnership
- Be selective: Consider the pros and cons of developing a partnership carefully – is there a less formal and less time-consuming means of addressing the issue concerned?
- Be clear on outcomes: Being specific about the desired objectives will provide a focus throughout, including while evaluating a project’s impact.
- Be realistic: A failure to deliver overambitious aspirations can lead to cynicism. It is much better to be realistic about what can be achieved. This can be built on over time.
- Be flexible: As contexts change, partnerships have to adapt. There should be an ongoing challenge regarding the value provided relative to costs.
- Be engaged: Meaningful involvement of frontline staff and patients from the outset will help to increase a partnership’s legitimacy and ensure it is addressing the issues that matter.