Keeping the faith in cross-sector partnership working: how to maintain motivation and drive

To reduce inequalities and improve health and wellbeing for communities, NHS, local authority and voluntary, community and social enterprise (VCSE) organisations are increasingly required to work in partnership. Formal health and care structures such as integrated care boards (ICBs) and place-based partnerships now better reflect this, but there are still barriers in the form of behaviours, cultures and incentives that cling to older, more siloed ways of working. Partnering is not easy, and those who try to work in this way risk becoming disillusioned and burnt out. 

This long read sets out six ways to enable those working in partnerships in health and care – whatever their arrangement – to maintain momentum and drive. Our recommendations are drawn from the experiences of five local partnerships in the voluntary and statutory sectors who have been working for several years to improve the wellbeing of their local communities through the Healthy Communities Together (HCT) programme.  

Our five partnerships are in Leeds, Croydon, Coventry, Gloucestershire and Plymouth. You can read more about them here.

Why maintaining motivation is important 

Healthy Communities Together (HCT) is a partnership between The King’s Fund and The National Lottery Community Fund and was set up to understand and address some of the intractable barriers to partnership working between voluntary and statutory organisations. The aim was to share learning and offer insights to enable local and national initiatives to develop and support partnership working. The programme explicitly created space and time to think differently, and gave partners the permission and encouragement they needed to do so. This was often in tension with ‘normal’ ways of working. Through the programme, members were explicitly aiming to change the status quo – something that is never comfortable because of the constant pull back to business as usual.  

Over the course of the programme, each partnership has had to work through challenging global, national and local circumstances. HCT began in the second year of the Covid-19 pandemic, with all the disruption, grief and uncertainties that brought. On its heels was the cost-of-living crisis, further impacting the populations these organisations serve, at the same time as putting additional pressure on their day-to-day work. And all this alongside large-scale structural changes brought about by the Health and Care Act 2022. One of our sites experienced local council bankruptcy, while others saw voluntary sector funding significantly reduced. One common challenge was that people changed jobs or roles – within and out of the partnerships – or moved into or out of local areas. 

A constant theme has been how members have maintained – and how they might continue to maintain – their motivation and continuity over time. This isn’t something that just happens; there are both individual and broader circumstances that can strengthen (or undermine) motivation and continuity. Partnering is not easy, and these challenges are common. Yet our partnerships – and the majority of those working together through them – have kept going, have kept ‘showing up’. In this long read, we highlight some of the features that have supported continuity, and what our members have found helps them to ‘keep the faith’ – to stay motivated and committed to their work, sharing, learning and offering hope to others. 

It’s important to recognise that continuity doesn’t mean stagnation or simply continuing to do the same thing. A key motivator for joining these partnerships was the realisation that the status quo is not working and the desire to try something different. Evolution, flexibility and adaptation are all aspects of continuity. Understanding what you can let go of (such as established ways of working that no longer fit new contexts), as much as what you need to hold onto, is essential.  

Rather than trying to hold steady a thing called a ‘partnership’ to deliver a task, it is more productive to focus on developing the skills and relationships to collaborate – or ‘partner’ – well across the system, whatever the organisational context. - Maybin and Fenney 2021

We offer six ways members have been ‘keeping the faith’ – that is, maintaining, developing and evolving their partnerships in response to the changing world around them. This isn’t a how-to guide. Rather, it is our observations and reflections on the experiences of partnership working, informed by what we have observed in the HCT programme.  These cover individual and group factors, because as we noted in a previous piece:  

Finding motivation as individuals  

Personal motivation and finding value alignment is key 

When an individual’s sense of purpose or values is aligned with that of the wider group, this can protect against burnout. There was widespread agreement among partnerships that the current status quo in health care is not serving local people or addressing health inequalities sufficiently. This was what had brought many of them to the programme in the first place, and they felt excited and inspired to try something different. That some still referenced this three years later highlights the importance of this motivation against the scale of the task. Several members also talked about how their personal values kept them involved, even when the work was difficult. Their commitment to serving their local communities was central to this. As one member reflected:  

When I’ve been at my wobbliest, I came back to ‘[It’s been] 20 years of working this way [ie, established ways] and health inequalities are still getting worse and not better. 

There are different ways to encourage members to act on their motivation. In the HCT programme, partnerships had spaces for thinking differently and resources to make use of these spaces through ensuring external consultancy support and facilitation for each area. Taking time to think differently also involved reflections and discussions about members’ values and the reasons why they were involved in this work. Finding ways to increase the work’s legitimacy to others in their local systems was also important – for example, HCT provided the banner of two high-profile brands to work under (The King’s Fund and The National Lottery Community Fund). Neither of these factors is unique to the HCT programme and may be useful ways to enable members to align themselves with partnership aims in other contexts. 

Recognise and appreciate your own impact 

Developing your own capacity to make change and seeing the difference it makes is also important. Throughout the programme, members developed their personal efficacy, such as their ability to reflect and intervene to make meaningful change in local systems. In one partnership, members described the importance of their own experiential learning, and their aim to help others to ‘go on their own journey’. They described how creating spaces for collective sensemaking among partners in the system, and modelling their own new ways of working, helped support others towards sustainable, creative and collaborative partnerships. In this way they also benefited from seeing the impact they were having on others. Being able to articulate what your partnership is trying to achieve together, and understanding the impact it’s having, is important for motivation on a personal as well as partnership level. It’s also a really important tool in helping other stakeholders to have confidence to keep working with them to achieve real change. 

Find connection with others (peer support) 

Finding encouragement within the work helped members to maintain motivation. People who are committed to their values and to supporting others don’t always consider their own needs. Returning to your own sense of purpose and prioritising your needs can help protect against burnout. Being able to receive support from, as well as give support to, others was another key principle. As one member explained, it helped them ‘feel less alone in the work’. This might be through regularly meeting with other partnership members locally, enabling sharing of ideas and challenges, and building strong relationships with these colleagues (for more on this, see ‘Partnering for change’ section 3, ‘Building relationships within the partnership’).  

Members also saw first-hand how having a cross-sector group can benefit their work. Partners were exposed to a wider range of ways of working via the skills and experiences each member brought to the partnership. They experienced diverse styles of working or tapping into different networks than they might usually be a part of, inspiring new ideas and actions. In one partnership involving a local infrastructure charity, a member gave them insight into the role of different funders in the area. This enabled them to co-ordinate their approach with other local charitable funders, such that during the pandemic they managed to create a single point of access for grassroots organisations to these charitable funders and the local council. Of course, working in this way could also involve tension, but this could be productive to achieving aims, as one member reflected: 

Open dialogue is critical to strengthening partnership working as this brings to light different opinions, partners feel more involved and solutions to problems are worked through. I mean, I knew about that anyway, but I suppose it’s one of those critical things that if you didn’t have that, we’d be in trouble.

Finding networks of other people involved in this kind of work beyond your local context can also be helpful. One part of the HCT programme was the opportunity to attend cross-partnership events. These were facilitated as spaces where sites could share reflections and learning with each other as well as learn about particular concepts and tools that could help address issues they had collectively identified. We witnessed members from different partnerships realising that their issues were shared across areas, and taking strength from that and connecting on different ways to approach solutions. 

Finding motivation as a partnership or group  

Maintain a sense of shared purpose 

Without a sense of shared purpose, motivation can wane. As a member of one partnership pointed out: ‘You don’t always get to choose who you partner with’. Sometimes members bring quite different agendas and aims. One partnership really struggled to develop a common agenda across members from different organisations. Acknowledging this as a group enabled them to address the issues they faced in keeping their HCT work a priority focus. Partnering is not always easy or fully successful. Being able to recognise this and find ways forward is also important.  

Other partnerships paid attention to maintaining their shared purpose by continually revisiting, reshaping and reaffirming their purpose over the years. One member described this as a ‘coherence of intent’: 

Although we didn’t have a set plan to align ourselves with, we did have a coherence of intent – of what we wanted to try and achieve, without prejudging what it was we had to do in order to achieve that… It’s kept everything buoyed up when things have not worked and people are feeling ‘are we making a difference at all?’, that coherence of intent has always been there and lifted people back up again.

Members recognised the importance of consistency of purpose given the continual draw towards business as usual. Legacy work and building the sustainability of their work was a key concern of partnerships throughout. Partnerships were focused on how they might continue to pursue their aims, even if the partnership as an entity didn’t exist anymore. This was not easy; one programme manager described worrying about ‘what does January 2025 look like’ in the context of cuts to ICB budgets, staff changing, and HCT sometimes being seen as ‘nice to have’ when essential services are being cut. They were concerned about how to support the work beyond the end of the HCT programme, even in a challenging external context. 

Another partnership’s commitment was demonstrated in framing their aim as catalysing something with stakeholders that will be able to develop after the HCT programme ends – an ongoing legacy with stakeholders, as opposed to a defined project endpoint. Understanding and recognising what they can and can’t achieve during the programme helped them to focus on what achievements they could gain from the work and who they needed to influence and share with. The extended timeline of partnership working can be difficult to grasp at first, and can cause tension among those not directly involved, as there can be little visible progress for some time. But it’s vital to understand that meaningful change cannot happen overnight. Members also recognised the slow pace of progress because of the time it takes to build trust with communities who have been marginalised: ‘There will be movement – but the shift is at the rate of tectonic plates.’  

Consider how to maintain representation of membership 

In service of partnerships aims, members saw the importance of keeping a broad membership so that the work doesn’t get skewed towards a particular member or organisation. Partnerships were originally formed to include VCSE, NHS and local authority (usually public health) membership. Maintaining this means getting the right people in the room for key decisions and influencing, ensuring that there is an appropriate balance so that no one organisation or group of organisations dominates that. As noted earlier, the HCT programme aimed to encourage members to work differently. However, the pressure to revert to the status quo – through processes, ways of working or even ingrained behaviours – was strong. For example, VCSE-sector members had to guard against slipping into default ways of working in relation to each other (eg, competition caused by historic commissioning arrangements) and in relation to statutory members. Members described having to continually make the case for VCSE-sector involvement and recognition of their specific skills and expertise. This happened within the partnership but also showed up in the interface between the partnership and the wider system. Members described how local commissioners weren’t always on board with the model the partnership was working with, meaning ‘we end up having to prove the value and ability of the VCSE again and again and again’. 

Over the programme’s three years, keeping a multi-sector partnership together was not easy. Several members or organisations named on initial bid documents have changed – for example, there have been significant restructures in many health care organisations. Having to (what feels like) start all over again in developing a new relationship with someone, and take the time to induct and welcome them, can be demotivating. Acknowledging this frustration is important – as well as the potential opportunities to ‘really get somewhere this time’ or ‘have another go’. Despite the challenges our partnerships have faced, three successfully maintained a balance of statutory and voluntary members throughout. This was through an ongoing effort to invest in and maintain those relationships with organisations even when individuals moved on – making time to get to know people, as discussed in ’Partnering for change’ section 3. Members in one partnership shared the changes they have gone through when they lost key partners from the system. One talked about how they reframed their role as a partnership:  

How much the change has challenged them to think about what is stable for them and what is the driver for the work they are doing even though people may come and go, they still need to maintain their principles. We are agile, a coming together of like-minded people who are passionate about what they want to achieve. So, when people leave, we are not offended but recognise our role in bringing people together.

This was not always possible, and one partnership in particular struggled when a statutory colleague moved on and their role was not replaced, which made it difficult to identify who in that organisation to re-establish a relationship with. However, where we saw ‘warm’ handovers – for example, where the exiting colleague came along to a partnership meeting with the colleague who was replacing them – this helped to maintain continuity in terms of keeping that organisation linked into the partnership. 

Consider how to maintain momentum through governance and rhythms of convening 

Several of our partnerships described processes of governance they had developed, or different rhythms of convening, which supported the continuity of the work. Each had worked out its own process that suited the unique circumstances of that partnership – from very informal (but weekly) spaces to more formal monthly board meetings. We observed that having a dedicated project manager, consultant or ‘convenor’ to track progress against plans and/or convene meetings was helpful in this regard. Importantly, they had intentionally developed these spaces and tested (and in some cases altered) governance processes to suit.  

For example, one partnership found, in contracting with a particular organisation as a delivery partner, that the usual contract materials and risk management tools didn’t fit with the different, more relationship-based approach they wanted to take. They developed alternative ways to contract, using a memorandum of understanding (MoU) and a ‘polarity mapping’ tool to support exploring key issues within the MoU. They were clear that this was about good governance and using it to build trust between funded and funder. These intentional rhythms and processes helped to support continuity – both through building trust among members with their regularity and supporting different ways of working (see above). This was also reflected in the overall programme management style, which aimed to be permissive and developmental.

Final thoughts 

We hope that sharing these reflections will spark some ideas and thinking for others about what might help for their partnership context. The breadth and complexity of initiatives involving committed people working together to address the health and care needs they see in their local communities is clear. We know that co-ordinating care across services is increasingly vital, and this requires people to partner in new and often complex ways that are likely to involve changes to old ways of working in terms of behaviours, cultures and incentives’. ‘Keeping the faith’ – staying motivated and committed to their work – is ever more important. As Audre Lorde, the writer, feminist and civil rights activist, described: 

At the same time, while we are surviving in the mouth of this dragon, we also need to be feeding our vision… Which is one of devising a future where we will live someplace other than the teeth of the dragon. If not in my lifetime, or even in my children’s lifetime, that we would all contribute to what is known as ‘the great going forward.’… I do believe… that if we can survive and if we can teach, if we can keep this whole crazy [vision] going long enough, we will find a way out.