Challenges and ways to overcome them

As well as the essential components, we identified some common challenges the partnerships faced.

  1. Representation and governance
  2. Demonstrating impact
  3. Culture change
  4. System complexity

Representation and governance

It is vital that the voluntary sector is involved, engaged and represented within strategic decision making and system transformation.

Voluntary sector reps can bring intelligence not accessible to public sector bodies, can work creatively and at pace, and can present new solutions to problems.

There are a number of real and perceived challenges associated with this.

  • Who is best placed to do this?
  • Will the representative be there to promote their own organisation or represent the wider sector and community?
  • How can we avoid conflicts of interest?
  • How will the views or smaller groups and organisations be included?
  • How will the voice of those most excluded be amplified?

These can be overcome by having:

  • written terms of reference (ToR)
  • open and transparent recruitment and selection process with a role description
  • mechanisms in place to listen the views of the wider sector and to provide feedback
  • more than one representative, for example a sub
  • representatives of particular communities (interest/place) or workstreams
  • remuneration to cover the costs of the representative attending meetings and any additional work as part of this role
  • a joint working agreement
  • a conflict of interest policy.

Example: Inclusive governance structure

In response to an emerging governance structure, the voluntary sector in Greater Manchester gained meaningful and inclusive involvement in the governance structure of the mental health work stream.

Enabling factors were:

  • voluntary sector reps recompensed for their time
  • a competitive and transparent selection process
  • the voluntary sector genuinely seen as an integral part of the system.

Key outcomes were:

  • increased skill and capacity of sector leaders
  • increased and consistent representation at all levels of planning and development
  • consistent feed-in from wider sector and process for feeding back
  • voluntary sector now seen as equal partners.

Demonstrating impact to people and communities

In any venture that requires people to commit time, it is important to demonstrate how it is making a difference to the health, care and wellbeing of communities and people.

Enabling factors

  • Shared vision Be clear on goals and how the work of the partnerships is going to achieve it.
  • Use measurement tools to agree and deliver agreed outcomes. These work best if jointly and collaboratively developed, not imposed.
  • Play to the strengths of the partners.
  • Align work to the ICS/STP plan.
  • Demonstrate the value of the partnership and the impact that working together is having on integrated care and the health and wellbeing of communities.
  • Communicate the partnership work and its successes.

Examples

  • All accelerator sites are aligning their plans with the plans of the STP/ICS to help fully demonstrate the impact of the voluntary and social enterprise sector as a transformation partner.
  • In West Yorkshire and Harrogate, voluntary sector reps oversee the ‘harnessing people and communities’ workstream and helped develop the voluntary sector strategy.
  • Cheshire and Merseyside Partnership is developing a five-year plan that aligns with that of its integrated care system.
  • Lincolnshire Voluntary Executive Team have a web portal and are developing an outcomes framework to demonstrate the impact their partnership makes.

Culture change

Reaching and engaging with people across all sectors can change the culture of partnerships, and lead to better outcomes for people and communities.

Culture is one of the most frequently cited challenges to effective partnership working. A partnership can have agreed goals, but if the culture in which they are operating is not enabling work to achieve them, it will most likely be ineffective.

Differing cultures across sectors and lack of real knowledge or understanding and value of each other can contribute greatly to culture clashes.

Enabling factors

Key outcome

An environment, where all partners across sectors are working together toward the same goal.

System complexity – what happens where

Health and social care transformation is highly complex – not only in terms of the clinical and social issues society is facing.

  • Systems (STPs/ICSs) are being formed covering geographical areas (sometimes referred to as footprints) that are unfamiliar and require new relationships to be forged.
  • This is an issue that many of the areas we followed are still grappling with, but many are working towards a structure that improves engagement and communication within sectors, across sectors, within service themes and within and across geographical boundaries. These structures are complex and take time and resources to develop effectively.
  • We have not yet been able to gather mature examples of these, however the image below demonstrates the complexity within the voluntary sector across Bristol, North Somerset and South Gloucestershire.