Healthy communities together – embarking on a journey of partnership working

Whether you are an NHS trust, local authority or voluntary and community sector leader, the changes afoot in how local NHS services are structured and commissioned will be on the minds of many. Setting aside the details of the Health and Care Bill, its underlying ambition is to support organisations to work more collaboratively, partnering to better serve the needs of their communities.

The Healthy communities together programme is a reflection of The King’s Fund’s commitment to developing long-term partnerships in health and care. Set up in 2019, the programme builds on The National Lottery Community Fund’s experience of supporting partnership working through grants to tackle the wider determinants of health, and on The King’s Fund’s practical experience of supporting leaders in health and care to develop collaborative ways of working and collective leadership.

'Underpinning the programme is a commitment to learning about what it means to partner...'

The Healthy communities together programme aims to support voluntary and community sector, local authority and NHS organisations to deliver a programme of change based on developing partnership working through £3 million in National Lottery grant funding, plus £850,000 of leadership and organisational development support from The King’s Fund. Underpinning the programme is a commitment to learning about what it means to partner, informing both the design of future programmes of support, as well as the work of organisations engaged in partnership working more widely.

So what are we learning from development of the programme? Well first and foremost is that developing effective partnership working takes time. The programme comprises an initial phase of nine months and a second phase of three years, where progression to phase 2 was dependent on demonstrating sufficient ‘distance travelled’ from where they started in terms of the partnership and plans. Our thinking was that this allowed sites time to make use of The King’s Fund support offer and hone their plans, while providing assurance that the commitment and capacity for partnership working would translate from paper into practice. Feedback about this from sites that proceeded to phase two has been positive. As one partnership shared – if they’d been given the green light from the start, they would have focused solely on their project plan to demonstrate delivery. The first phase provided the opportunity for a dry run, and importantly space to test and build ways of working as a partnership.

The initial nine months also provided the sites and our leadership and learning consultants with an opportunity to explore the value and purpose of The King’s Fund support offer. The application process required partnerships to outline how they might use the support available. However, it’s from doing the work that sites have really been able to identify what support they need, what has been of most value, and where they need more input. Similarly, this work has led us to question the role the consultants play in supporting the aims of the programme and the success of the partnerships. This has resulted in us redesigning the support offer for phase two, focusing on enabling a learning approach – between partners in sites and across sites. Furthermore, the offer will be co-designed, matching the wide range of skills and experience of the consultants to the emerging needs of the sites.

The evolution of that learning approach is generating new insights on what it means to ‘partner’. This isn’t so much about getting the work done but ‘how’ the work is done together. Key themes around the importance of purpose, membership and how to enable contributions from all partners has come up in all sites in different ways. As partnerships reflected on the first year, they noticed how their understanding developed iteratively through trying things out, learning together and really challenging themselves about their assumptions and beliefs about what partnering involves. We’ll be sharing more about our learning approach and the learning from partnerships so far in the coming weeks.

One year into a four-year programme, it’s clear we are very much in the early stages of the work. Our aim over that period is that the Healthy communities together programme will support partnerships to go beyond service design and delivery to address some of the structural barriers that limit partnership working between statutory and voluntary and community organisations. The grant funding ensures that everyone can be at the table, and importantly those community groups that might struggle to do so otherwise. However, it’s through our investment in learning alongside these sites, surfacing and encouraging partners to think about what they are learning that we hope to find ways of redefining those relationships and the barriers that prevent systemic change.

'It is our aim that they will be able to draw on the learning from the HCT programme to embed and build on partnership working long into the future.'

That sites have been able to make real progress over the past nine months, in the context of the Covid-19 pandemic and unprecedented pressures on the health and care system, is a testament to the value of partnership working and the opportunity that the Healthy communities together programme presents. Similarly, in our oversight of the programme, we have been able to draw on the unique perspectives and capabilities of both The King’s Fund and The National Lottery Community Fund in the development of the programme, which we envisage being equally valuable in ensuring that learning from the programme has suitable influence more widely. The pandemic required so many organisations to find common ground and work together. In moving towards recovery from Covid-19, it is our aim that they will be able to draw on the learning from the HCT programme to embed and build on partnership working long into the future.