Coach, facilitator, critical friend: The complex role of the consultant in cross-sector partnerships

Health and care organisations are increasingly coming together across organisational boundaries to try to tackle health inequalities and improve people’s health. But as anyone involved in this work knows, cross-sector partnership working of this kind is complex. 

Often, partnerships might commission consultants to support them but defining what a partnership needs can be challenging. Similarly, for a consultant, understanding how best to meet the needs and wants of a partnership can be difficult; what is needed and what is wanted aren’t always the same thing.  

As consultants, our work with the Healthy Communities Together (HCT) programme gave us the chance to explore the impact of providing consultancy support to multi-sector partnerships. Over the past three years, we’ve found ourselves moving between roles as coaches, experts, critical friends and facilitators to enable groups to engage with how they are doing their partnership work. To greater or lesser extents, we’ve taken up all three of the ‘classic’ consultancy roles as described by the American management theorist Edgar Schein: 

• doctor/patient – consultants diagnose client problems and offer solutions, training or education 

• purchase of expertise – consultants provide the capacity clients need (time or skills)  

• process consulting – consultants help clients to learn how to diagnose and solve their own problems. 

Although our roles have varied, so too has our clients’ understanding of partnership working. Some have seen HCT as a particular set of projects they’re trying to carry out together; others, as a way of doing work; others, as a way of being with each other; and others still, as a philosophy or basis for activism. What partnerships have wanted or needed from consultants has varied accordingly: some wanted help with programme management, others wanted a partner in reflection, some wanted workshops on a specific topic, and some wanted aspects of all of these at different times.  

Client groups likely always have their preferences, and these preferences may accord with local patterns of how consultants have previously been used. Consultants, too, will have their preferences about how they work, and may be used to applying the lenses through which they view the world to every client system, whether their clients want them or not. Ideally, the combination of perspectives will fit well.  

But when might agreement become collusion? When might challenge be satisfying the consultants’ needs for respect or status, rather than the emerging client need? These are things that consultants and partnerships grapple with on a daily basis. Here, Toby Lindsay, Senior Consultant at The King’s Fund, shares some of his experiences of the everyday practice of consulting to help bring some of these challenges to life.  

Toby’s stories and reflections demonstrate how much of a risk both partnerships and consultants take when they decide they’re going to step into the unknown together. They also raise a number of issues to consider – both for those commissioning consultants and for consultants themselves. 

Questions for partnerships and system leaders to consider when engaging consultants 

• What problem(s) are you hoping that a consultant will help with? What’s stopping you from addressing the problem(s) yourselves? 

• What kind of support do you think you need? Diagnostic, expertise, process consulting, or something else? How have you come to that conclusion and how explicit can you be about your reasons?  

• What do you know about yourselves and what you need as a group to accept support? 

• What qualities will you look for in your consultant? Which of those feel most important and why?  

Questions for consultants when engaging with partnerships and system leaders 

• What are the foundations of your credibility and internal authority in your work? Are these the same or different? How do they ebb and flow? 

• When are you most alive, engaged and effective in your work? What would it take to be more like this, more often?