Perspectives on Collaboration Masterclass Series

Understanding the Determinants of an Effective Partnership: Learning from Research and Practice

National Leadership and Innovation Agency for Healthcare and Social Services Improvement Agency 2008/09

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This report was prepared by Dr Paul Williams, Reader in Public Management and Collaboration at the Cardiff School of Management, University of Wales Institute, Cardiff

Any enquires and further information about this

Siân Harrop-GriffithsPartnership Development DirectorNational Leadership and Innovation Agency for HealthcareTelephone: 01443 233333Email: sian.harrop-griffiths@nliah.wales.nhs.uk

Martyn PalfremanBusiness ManagerSocial Services Improvement AgencyTelephone: 029 20468685Email: martyn.palfreman@wlga.gov.uk

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A series of Perspectives on Collaboration Masterclasses have been sponsored by the National Leadership and Innovation Agency for Healthcare and the Social Services Improvement Agency for Wales. This report summarises two of these – the first held in October 2008 and attended by 35 predominantly senior health and social care managers and practitioners from across Mid and North Wales, and the second held in March 2009 and attended again by 29 senior health and social care managers and practitioners from the South and West Wales areas. The focus of both Masterclasses was on understanding the effective determinants of partnership working – what are the key factors, influences, barriers and issues involved in shaping the course of collaborative working between people and organisations in the health and social care sectors?

Professor Bob Hudson from Durham University, and a leading exponent, writer and academic in the field of partnership working delivered the Masterclasses and this was followed by interactive group discussions on four key aspects of this form of governance as follows:

The Nature and Role of Trust in Collaboration Leadership for Collaboration Clarity of Purpose What is Success in Collaboration?

This report briefly summarises the main points arising from Bob Hudson’s presentation and is followed by a note of the deliberations of each group discussion framed where appropriate against a theoretical overview of the subject matter and some useful references.

INTRODUCTION

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A central thrust of Bob Hudson’s presentation was that there is a considerable body of knowledge, literature and research on partnership working which can be very helpful to policy makers and practitioners. However, although it can be an often tedious occupation to engage in definitional debates, in the case of ‘partnership’ clarity around terminology and meaning are very important because terms like ‘partnership’ and others that are used in this context such as ‘collaboration’, ‘cooperation’, ‘coordination’, ‘joint working’, ‘alliances’ and ‘integration’, mean different things to different people. In particular, these different notions can be achieved in different ways using different strategies and approaches. Hence, it is important to be clear and transparent about what people mean by the phenomenon of ‘partnership’ or any other term that is used to describe this form of governance.

Any definition of partnership needs to answer the questions – Who is involved? Who is doing what? With what means? And towards which ends? One useful definition is: “collaboration occurs when a group of autonomous stakeholders of a problem domain engage in an interactive process, using shared rules, norms and structures, to act or decide on issues related to that domain” (Wood, D.J. and Gray, B. 1991 “Toward a Comprehensive Theory of Collaboration”, Journal of Applied Behavioral Science, Vol. 27 No. 2 pp. 139-162)

Bob Hudson offered some general messages about partnership working including that there was much to be learnt about this form of working through direct experience although for whatever reasons such as lack of time, skill or inclination, practitioners were generally poor at reflective practice. In the context of a substantial body of knowledge – theoretical, conceptual and empirical – from different disciplines – political science, organisational studies, psychology,

PARTNERING: WHAT ARE THE RESEARCH LESSONS?by Professor Bob Hudson

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management science and economics – on different policy areas and levels of governance – there is no real mystery about the key factors and issues involved in getting partnerships to work

effectively. However, whilst many of these may be easy to say, they are very much harder to do in practice because of the inherent complexity involved and the problematic nature of the issues seeped in paradox, ambiguity and tension.

Bob Hudson proceeded to structure the remainder of his presentation around the Partnership Assessment Tool that he and colleagues have developed to help people and organisations both develop and evaluate partnerships. The assessment tool can be downloaded free from www.csip.org.uk or a more detailed explanation is available in two articles as follows:

Hudson, B. and Hardy, B, (2002) “What is a ‘successful’ partnership and how can it be measured?”, in Glendinning, C. Powell, M. and Rummery, K. (eds) Partnerships, New Labour and the Governance of Welfare Bristol: Policy Press

Hardy, B. Hudson, B. and Waddington, E. (2000) What makes a good partnership? Leeds: Nuffield Institute for Health

The Partnership Assessment Tool is grounded in the theoretical and empirical literature and distils this material into six principles, each with six messages. It is intended as a diagnostic tool for partnerships but can also be used for routine audit. It requires individuals within a partnership to make a judgement on how well a particular partnership is performing against the six principles, and a ‘partnership score’ is calculated to reflect overall progress with more detail on individual areas of strengths and weaknesses. It has been extensively field tested and has been much used in the UK and Internationally. Bob Hudson briefly outlined each of the six key principles as follows.

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1. Recognise and Accept the Need for Partnership This principle covers some of the antecedents and precursors to partnership working. It concerns the context and particularly the history of partnership working in a particular community or policy area. The importance of valuing what has been achieved in an area or between particular partners is

considered to be a good starting point and undoubtedly success breeds success – hence, identifying the factors that have led in the past to effective collaboration is likely to pay dividends. Also, partnership working invariably faces a number of barriers: cultural, professional, organisational, financial and managerial – and these need to be recognised and addressed. The motivations to work in partnership can be multiple and diverse –they stem from voluntary expressions based on resource exchange, mutual learning and client-focused services, but they can also be mandated by government through statutory duties and financial frameworks. Clearly, different types of motivation can set a different tone to the prospects of an effective engagement between people and organisations. At the root of partnerships lies a need for partners to be both aware of the areas of independence between themselves and other organisations and also to accept this – often that single organisations acting autonomously cannot resolve the complex and interrelated issues involved in health and social care. However, whilst there may be clear areas of interdependence between organisations which require them to work in partnership, this mode of operation is not a panacea for all forms of management, and it is critically important to identify the boundaries between organisational ‘core business’ which it gets on with alone, and ‘partnership business’ with which it works with others.

2. Develop Clarity of Purpose and Realism of PurposePartnership working involves a diverse set of people and organisations coming together to achieve forms of common purpose. They represent a kaleidoscope of cultures, backgrounds

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and professions with different views, frames and ambitions about the way forward. Therefore, the importance of negotiating shared vision, shared values and agreed service principles cannot be overestimated. In addition, these need to be translated into clear and realistic aims and objectives to guide collective action and to provide a background against which the success of the partnership can be gauged. This process is bound to tease out individual motivations for partnership working and transparency at all times between partners is an important aspiration to work towards. Finally, the experience of many partnerships suggests that being over ambitious at the outset and focussing on the most difficult problems is not the best strategy – given the often protracted and complex nature of partnership working, it is more realistic to identify easy targets or

‘quick wins’ to work on and deliver – early successes give the confidence to partnerships that they can work effectively together and this ‘capital’ can then be used for more challenging tasks in the future.

3. Ensuring Commitment and OwnershipIt is clear that partnership working will not flourish if there is not commitment to, and ownership of, this mode of governance. It is different from other forms of working, involves making compromises, sometimes losing or sharing power and can be very time consuming. Commitment must start at the top of the organisations concerned by senior managers – they need to give clear signals to the rest of the organisation that partnership working is a legitimate response to the problems they face, and they have an important role in both encouraging, supporting and facilitating this form of working. In addition, ownership needs to be dispersed both horizontally and vertically in organisations to allow partnership cultures to grow organically and ensure integration between policy makers and implementers on the ground. Partnership working is also ‘not only for Christmas’ and consistency of commitment needs to be sustained over time – there will be times when it is difficult

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and it is easy to walk away – but the benefits to service users require energy, drive and commitment. One way of enthusing commitment and ownership through organisations is to nurture key individuals with networking skills who transcend the ‘normal’ communication routes – such individuals work in social space and connect in a web like fashion to like minded people at different levels and interests in partner organisations – these people are sometimes referred to as ‘boundary spanners’. However, although dedicated boundary spanners can have enormous value in supporting partnership activity, it is important that the impression is not given that partnership is their sole responsibility: partnership cultures are required by a whole range of people undertaking mainstream jobs within organisations. Finally, it is critical that ways are found to reward partnership working and conversely to penalise inappropriate unilateral activity that can destabilise or undermine trust between partners. Rewards for partnership working do not need to be financial but Human Resources and OD strategies need to recognise this form of management.

4. Developing and Maintaining TrustThere are three types of social organising – markets in which price is the primary means of communication, hierarchies where routines and authority are the main mechanisms, and networks (of which partnerships are an example) where trust is the lubricant of exchange relations. Therefore, developing and sustaining trusting relations between individuals and organisations is arguably the most important determinant of effective relationships. This begins from a recognition of the value of each partner’s contribution – these contributions will often be unequal because of the uneven distribution of power and resources between partners. There needs to be fairness in the conduct and governance of partnerships – communication is critical and decision making frameworks need to be equal between all parties – in particular decisions need to be made within formal arenas and not negotiated outside by small cliques of the more powerful agents. Although partnership working is based on promoting collective action, there is inevitably a degree

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of self-interest involved by individual partners and a consequent need to distribute the benefits of partnership working in a fair manner – these benefits may not accrue to all partners at the same time and may be released in different ways over a longer time period. Single organisations acting autonomously can institute various rules, systems and mechanisms to control and manage risk. However, working with people and professionals from other organisations constitutes an increased level of risk – many decisions and behaviours cannot be controlled in the same way. Therefore, they have to rely on sufficient trust to enable this form of working to develop in ways that cannot always be anticipated in advance and to withstand inevitable problems and threats that bubble up in the external environment which often alter the context of the partnership. There is a strong view that effective partnerships are essentially the outcome of dedicated individuals who are committed to making this form of working a success despite structural, professional, financial or other barriers – it is getting the right people, in the right place at the right time. However, this is not easily achieved in practice and ‘luck’ may play a part in deciding who is involved in particular partnership groups. On the other hand, more careful selection of partners, skills development and training can reduce the element of luck. 5. Clear and Robust Governance ArrangementsWorking in partnership is often perceived to be attractive because it may be seen to involve a more flexible and looser form of organisational arrangement. However, the evidence suggests that close attention needs to be invested in the governance of partnerships to avoid confusion, lack of co-ordination, inappropriate action and unclear accountabilities. Partnerships need to focus on process and outcomes rather than structures and inputs, although governance arrangements need to be clear and robust. Transparency is important both to the participating organisations and to the recipients of the outcomes of the partnerships – service users, patients, clients and citizens. There needs to be clear lines of accountability and clarity of respective responsibility – converting

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strategic intent into action on the ground is often fraught with difficulties and action plans need to be clearly set out and agreed between the respective parties – who does what and when is important. Problems inevitably centre on finance and there is an onus on the partnership to ensure transparency in any financial commitments, but also that there is recognition of the significant non-financial contributions that are made by partner organisations to secure effective and efficient working – for instance, in terms of staff secondments, training, use of buildings, administrative assistance and equipment. There is a danger that the governance of partnerships becomes overly bureaucratic, cumbersome and rule-bound – the message is that any arrangements should aim to be simple, time-limited and task-orientated. Too many partnerships continue for long periods of time without really adding value!

6. Monitor, Measure and LearnOne of the many problems of partnership working is lack of clarity about purpose and the failure to convert high level ambitions and visions into practical actions on the ground. It is important from the outset of the partnership process to gauge what is meant by ‘success’. Indeed, this may differ for different stakeholders and interests. Success criteria, in terms of outcomes (process or substantive), performance indicators, targets or whatever, need to be agreed, and mechanisms and arrangements devised to monitor the extent to which these are being achieved. These need to be reported to the partnership governing bodies and disseminated to a wider audience. Double loop learning is to be encouraged to ensure that the original aims, objectives and arrangements of the partnership continue to be appropriate to the challenges being faced – the dynamic nature of the public policy setting means that organisational arrangements can often become redundant or inappropriate and there is a danger of not institutionalising particular collaborative solutions. The evaluation of the success of partnerships should focus not on its impact or service outcomes but in terms of the particular partnership process and arrangements – has the partnership been fit for purpose in terms of leadership,

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governance, accountability, composition and so on. These exercises are referred to as Partnership Health Checks. Finally, it is important to celebrate success – it rewards the efforts of the partners, engenders an increased motivation to work in a similar fashion in the future and clearly indicates to a wider set of stakeholders that this form of working is both legitimate and effective.

In conclusion, Bob Hudson ended the Masterclass with what he termed ‘six self-evident truths’ as follows:

Partnership working has no qualities of spontaneous growth or self-perpetuation – therefore, it is something that must be constantly encouraged, nurtured and supported.

Government does have an important role in setting the policy tone for partnership working. It can achieve this through mandate, exhortation or policy tools and mechanisms that help to promote and encourage partnership working

Local partnership strategies need a combination of top down and bottom up dimensions

At the end of the day, structures and frameworks help and hinder partnership working, but ultimately it depends on people – those who are for it and are prepared to work with people from other organisations and professions – trusting, compromising, learning, negotiating, networking and achieving results that could not be achieving by working independently, and those that are uncomfortable or even opposed to collaboration and hide behind the barriers of professional and organisation self-interest.

The reason for working in partnership is to deliver seamless services to vulnerable people - service users prefer this to fragmentation

Good partnership is eminently possible and the benefits are worth striving for – however, the complexities involved in this form of governance are undoubtedly complex and challenging.

Useful Publications from Professor Bob Hudson(2004) “Trust: Towards Conceptual Clarification”, Australian Journal of Political Science, Vol. 39. No..1 pp. 75-87.

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(2004) “Analysing Network Partnerships: Benson re-visited”, Public Management Review, Vol. 6 No. 1 pp. 75-94

(2005) “Not a Cigarette Paper Between Us”: Integrated Inspection of Children’s Services in England”, Social Policy and Administration, Vol. 39. No. 5 pp. 513-527

(2006) “Children and Young People’s Strategic Plans: We’ve been here before haven’t we?”, Policy Studies, Vol. 27 No. 2 pp. 87-99

(2006) “Integrated Team Working: You can get it if you really want it: Part 1”, Journal of Integrated Care, Vol. 14 Issue 1, pp. 13-23

(2006) “Integrated Team Working Part 2: Making the Inter-Agency Connections”, Journal of Integrated Care, Vol. 14 Issue 2 pp. 26-36

Useful Publications from NLIAH:Williams, P and Sullivan, H. (2007) Working in Collaboration: Learning from Theory and Practice

Williams, P and Sullivan, H. (2007) Learning to Collaborate: Lessons in Effective Partnership Working in Health and Social Care

National Leadership and Innovation Agency for Healthcare (2009) Getting Collaboration to Work in Wales: Lessons from the NHS and Partners

National Leadership and Innovation Agency for Healthcare (2009) Compendium of Innovative Practice: LHBs’ Perspectives of Working with Partners

Sullivan, H, Williams, P and Jeffares, S. (2009) Exploring Leadership for Collaboration

All available from www.nliah.wales.nhs.uk

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Useful Publications from SSIA:SSIA and Creative Exchanges (2008) A Strategic Approach to Planning and Reconfiguring Services for People with Learning Disabilities

SSIA and Institute of Public Care (2008) Commissioning for Better Outcomes for Children in Need

SSIA and Institute of Public Care (2007) The Role of Commissioning in Improving Services to Children in Need

All available from www.ssiacymru.org.uk

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Figure 1: Trust Matrix

DISCUSSION QUESTIONS Trust is often seen to be pivotal to building and sustaining

effective partnerships, but what is it? How is trust conceptualised? How can trust be built and sustained? Can you have trust between people and organisations? What happens if trust is broken? Can you still work with people in other agencies that you

don’t trust?

THE NATURE AND ROLE OF TRUST IN COLLABORATION

Degree of Trust

Expo

sure

of R

isk

HIGH MEDIUM LOW

HIGH

MEDIUM

LOW

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Trust can be mapped as illustrated in Figure 1. It is a dynamic notion and can change over time i.e. it can migrate between different sectors in the light of personal experiences or changing circumstances.

It can be defined as: “the voluntary exposure to risk”. It involves a calculation of the degree of risk one is prepared to exposure oneself. The danger of exposing oneself to risk is that some harm (referred to by the discussants as ‘being shafted’) may be done to you by a party that you have trusted.

Trust sometimes involves a ‘leap of faith’ particularly in a new relationship where you have no previous knowledge on which to base your judgement. Often, you have pre-conceived ideas of people in other organisations and this will colour your view on how much to trust people within them; the trouble is that we often label all people in a particular organisation with the same brush, and this may not reflect the behaviour of individual actors within them.

How can trust be built? through a better understanding of people’s roles and motivations by meeting/socialising with people outside working hours by engaging with people outside their work role/context by making the first overture to say sorry if trust is broken (but

what if this is not reciprocated?) Trust needs openness, understanding of both sides’ aims; it’s

about achieving the same goals and is grounded in personal relationships

Trust is engendered in partnership decisions relating to who is invited to participate, how the agenda is set, who chairs the meeting and what tone is set within partnership arenas. If there

KEY POINTS FROM THE DISCUSSION IN NORTH WALES

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are partnership cliques running the affairs, then this undermines confidence and trust.

Trust can be a function of the frequency of contact and communication with other parties and of their commitment to work together.

Trust is about the integrity of personal relationships, and getting to know people behind their organisational face and role is very important. Conversely, representational roles and people who are trapped within their professional and organisational cages constitute barriers to trust building.

Opportunities to network are important so that people can get to know each other on a personal basis and inevitably this takes time.

It is possible to orchestrate behaviour and decisions at formal meetings based on informal understandings and a prior appreciation of people’s political sensitivities and constraints. However, there is a problem of making decisions outside meetings and ‘only going through the motion’ at formal events e.g the voluntary sector often feel it is left out and marginalised, and having a situation in a partnership of ‘senior’ and ‘junior’ partners is not good for promoting trust.

Trust operates in a dynamic fashion – spiralling upwards in a virtuous circle – with trust being repaid and reinforced – but conversely it can also spiral downwards when trust is broken - often at a faster rate.

Personal relationships can be blown away by major structural change and turbulence such as that currently being experienced in the health service. What happens in these circumstances when people move posts or disappear altogether from the scene? Inevitably, something will be lost but will the accumulated trust capital in an area of partnership remain in the system? Comments included:

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there is a problem of size in the new unitary health organisations – can they be approachable and sensitive to local needs and interests?

the new organisations will not focus on the partnership agenda but will concentrate on ‘getting their own house’ in order – they will be looking inwards to ensure they are fit to discharge their core duties and responsibilities and looking outwards may be a secondary concern

why is it in times of structural change that the focus is not on building and sustaining ‘social capital’? It’s all about money, structures and systems and not on people and relationships!

What are the practical ways of creating trust? Comments included:

“people should do what they say they are going to do, when they say they will do it”

delivering on promises sticking with people during difficult times handing delivery failure (breaking trust) in an open and

transparent fashion can relationships be too close so that hard decisions are not

taken because everyone is being too nice to each other?

Trust is a function of honesty and can you be thoughtful when you have to renege on a promise or harm someone? Comments included:

forms of ‘shafting’ – blatant, inadvertent and apologetic how long will a relationship last if you are ‘shafted’? i.e. ‘will you

still love me tomorrow?” - depends on the number of times/strength of the ‘hurt’

There is no alternative to trust for deep and sustainable change – it is very fragile and can explode at any time

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Trust is about personal relationships and we have better relationships with some people than others; it is possible not to like people but to respect them

Trust is the confidence that someone will deliver on promises – a good professional can do this and this does not necessarily involve a personal relationship

‘having friends at work is a bonus’; you can trust people that you would not choose to spend any social time with; it’s about setting and constructing the boundaries of that relationship – it needs to be stronger for professional relationships than with personal relationships

past experience is important – good or bad – you are not going into a vacuum in partnership working and often individuals are badged with the organisational baggage of previous encounters

it is important to share information as a prelude to building trust and counter mistrust – e.g. sharing financial information and quarterly monitoring reports between health and local government – this initially involved a leap of faith and a risk that the information would not be misused – it is not being sure of the outcome – and in this case the other party reciprocated in good faith which stated a process of trust building

trust is difficult when partner representatives constantly change at meetings; similarly if key people exit the partnership; trust relationships can be fractured

What happens to relationships in times of organisational turbulence? Legacy statements are being produced across Wales to emphasise the need to preserve valued aspects of the existing partnership architecture between health and social care

People start with either a predisposition to trust or a predisposition to distrust and then wait to evaluate the evidence

KEY POINTS FROM THE DISCUSSION IN SOUTH WALES

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There is no such thing as ‘trust dust’ that can be sprinkled around – trust is created through doing things together, shared experiences and particularly success; there is a need to engineer encounters to get people to work together either formally or informally

‘playing fair’ is important in partnership working – being open and honest and transparent – this builds trust between people and organisations especially when compromises are made

the key question is “Can I do business with you?” – it is a judgement about an individual and involves knowing about the reputation/ integrity and ability to deliver on promises of that person, and about judging the relationship in practice

you can indulge in tactical collaboration with people you don’t trust but this does not involve taking large risks

alternative to trust is contractualisation time is really important in building trust

Trust is the subject of a substantial body of inter-disciplinary theory (Lane, 1998; Boon, 1994; Lewicki and Bunker, 1996; Cummings and Bromily, 1996; Das and Teng, 2001; Sydow, 1998) which is considered at a number of different levels of analysis: personal, organisational and inter-organisational. It has no universally agreed meaning and is the subject of a diverse set of theories, concepts, models, perspectives and definitions. Various models of trust associate the concept with faith, predictability, goodwill and risk taking. Lane (1998) offers a list of common elements in conceptualisations of trust including (i) an assumption of a degree of interdependence between the trustor and trustee; in other words, it

PERSPECTIVES ON TRUST

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is a property of a relationship, (ii) trust provides a way of coping with risk or uncertainty in an exchange relationship, and (iii) trust is a belief or expectation that the vulnerability resulting from the acceptance of risk will not be taken advantage of by the other party in the relationship. Lane goes on to suggest that the basis of trust can be derived from three main sources - calculative, value or norm based and common cognition. Calculative forms of trust are those based on the rational choice model and represent a kind of cost-benefit analysis of taking certain courses of action.

Boon (1994) presents an example of this approach in relation to romantic relationships and, interestingly, there may be parallels with relationships in partnerships. She refers to three distinct stages in the development of interpersonal trust - romantic love, evaluative and accommodation. The romantic love stage is characterised by “a profusion of positive feelings” and “expectations about a partner.... are little more than tentative theories that speculate, in the absence of real data, that the partner’s feelings and motives are essentially equivalent to his or her own” (Boon, 1994:91). This stage is inevitably replaced by an evaluative phase in which the parameters of the interdependence are assessed and, with more information, a more realistic agenda crystallises. Boon offers a number of criteria to guide such an evaluation - dependability, responsiveness (being self-sacrificing), capacity to resolve conflict and faith - “a sense of closure regarding the question of a partner’s trustworthiness and the relationship future” (Boon,

1994:99). It is doubtful, however, whether closure is in practice possible, and a range of issues are raised in circumstances that lead to the failure of trust and where the degree of trust in a relationship falls somewhere between the two extremes of trust and mistrust. The third stage of Boon’s model is termed the accommodation stage where “partners must seek mutually acceptable solutions to areas of incompatibility and opposing interests exposed during the preceding stages” (Boon, 1994:95). Lewicki and Bunker (1996) embrace Boon’s model to help understand trust in professional

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relationships. Their understanding of trust is very much an explicit calculative and perhaps arithmetical perception. A three-stage model is expounded - calculus based, knowledge-based and identification-based. Trust is not a static concept and it clearly has a dynamic which can move in one of two directions – upwards in a spiralling fashion as a product of mutually reinforcing behaviours, favourable attitudes, moods and emotions or conversely downwards in a spiral of distrust where negative effects are felt (Vangen and Huxham, 1998). It is likely that trust spirals downwards in a faster rate than it does upwards and is more difficult to repair. Certainly, trust is constantly being evaluated either consciously or otherwise.

Another version of trust is value or norm-based trust which infers a moral basis or social obligation - trust is, therefore, seen as a belief consisting of the essential ingredients of commitment, honesty and not taking advantage of another. It projects an optimistic view of individual behaviour in contrast to interpretations within economic literature that emphasise competition as the basis of human interaction. Lastly, the common cognitions view of trust refers to systems of shared meanings of which Sydow (1998) identifies three types - process-based which is rooted in personal relationships and can include technical competence or knowledge; characteristic-based which related to personal characteristics or qualities; and institutional-based which is founded on traditions or professions.

Jones and George (1998) refer to notions of conditional and unconditional trust. They define conditional trust as “a state of trust in which both parties are willing to transact with each other, as long as each behaves appropriately”. Here there is a strong incentive to begin a relationship with trust, in particular because it saves the time and energy of working out the other party’s value systems and beliefs, although it does make them more vulnerable. The evolution of conditional trust between two parties depends on favourable attitudes and expectations between various exchanges in the relationship, and the security that they will not be harmed or put at risk by the other

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party. In contrast, unconditional trust is rooted in shared beliefs which structure the social system, where each party’s trustworthiness is assured based on the confidence in the other’s values that is backed up from empirical evidence derived from repeated behavioural interactions. In this situation, there is a sense of mutual identification between parties.

Bachmann (2001) refers to trust as a mechanism for coping with uncertainty and complexity, and there are theories that position trust at both a personal and system level. Also, Bachmann (2001) is anxious to stress the relationship between trust and control, both being mechanisms for co-ordinating social interactions. Similarly, Hardy et al distinguish between real and simulated trust, and attempt to disentangle the two heavily loaded notions of trust and power. They suggest that most functional interpretations of trust: “Ignore the fact that power can be hidden behind a façade of ‘trust’ and a rhetoric of ‘collaboration’ and can be used to promote vested interests through the manipulation and capitulation of weaker parties” (Hardy et al, 1998: 65).

REFERENCESBachmann, R. (2001) “Trust, Power and Control in Trans-Organizational Relations”, Organisation Studies, Vol.22 No. 2 pp. 337-365

Boon, S. (1994) “Dispelling Doubt and Uncertainty: Trust in Romantic Relationships in Duck, S. (ed) Dynamics of Relationships London: Sage

Cummings, L.L. and Bromily, P. (1996) “The Organizational Trust Inventory (OTI), in Kramer, R.M. and Tyler, T.R. (eds) Trust in Organizations London: Sage

Das, T.K. and Teng, B-S. (2001) “Trust, Control and Risk in Strategic Alliances: An Integrated Framework”, Organisation Studies, Vol 22 No.2 pp. 251-283

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Hardy, C. Phillips, N. and Lawrence, T. (1998) “Distinguishing Trust and Power in Interorganisational Relations: Forms and Facades of Trust”, in Lane, C. and Bachmann, R. (eds) Trust in and Between Organizations Oxford: Oxford University Press

Lane, C. (1998) “Introduction: Theories and issues in the Study of Trust”, in Lane, C. and Bachmann, R. (eds) Trust in and between Organisations Oxford: Oxford University Press

Lewicki, R.J. and Bunker, B.B. (1996) “Developing and Maintaining Trust in Work Relationships”, R.M. and Tyler, T.R. (eds) Trust in Organizations London: Sage

Sydow, J. (1998) “Understanding the Constitution of Interorganizational Trust”, in Lane, C. and Bachmann, R. (eds) Trust in and between Organisations Oxford: Oxford University Press

Vangen, S. and Huxham, C. (1998) “The role of trust in the achievement of collaborative advantage”, presented at the EGOS Colloquium, Maastricht.

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Leadership for Collaboration should be based on having a broad perspective and not being overly self-focussed. It involves being able to practice the following:

fostering trust between people at all levels using a ‘common language’ and helping to translate between

different professional lexicons helping to set a vision and clarifying the implications of this for

different partners moving away from an organisational focus and self interest to a

broader view of the greater good avoiding being self-obsessed promoting effective communication and engagement with and

between all interests having an ability to be strategic but at the same time maintaining

a personal touch having a clear focus on service users and citizens not on one’s

own organisational interests avoiding professional and organisational protectionalism and

being able to ‘think outside the box’ having problem solving skills and being prepared to take risks

How do you build ‘authority’ across a partnership if you are not in a position to instruct others i.e. you do have ‘positional power’?

LEADERSHIP FOR COLLABORATIONDISCUSSION QUESTIONS Does the context and nature of collaborative arenas

demand a particular approach and style to leadership? If so, what form should leadership take and what are the

particular skills and abilities needed by leaders to operate effectively in collaboration?

Does this differ from leadership within markets and hierarchies?

KEY POINTS FROM THE DISCUSSION IN NORTH WALES

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Importance of inter personal relationship and building trust – “you do things for people outside formal meetings – trust is based on delivery – calling in favours – treating people with respect”

Trust is especially important in non-hierarchical situations i.e. partnerships

‘you are who you say you are and do what you say you will do – this creates trust’

Need for clarity of purpose, measurable outcomes and forms of accountability; having a vision of what you can do together that you cannot achieve independently

Summary of Leadership for Collaboration It needs a broader strategic perspective involving clarity of vision

and purpose It needs leaders to put themselves in positions of creating ‘a

greater good’ by focussing on users and citizens – not on their own organisation’s needs and interests

It needs leaders to translate ‘purpose’ into a common language for all professionals and users

Leadership for collaboration needs leaders who are not primarily functional, as in many individual organisations, “but the trouble is that too many partnerships are led by organisational leaders” who are good at project management, financial planning but too immersed in detail and averse to risk taking. They don’t have visionary traits, are not strategists and don’t have charisma/charm. There is a need for risk takers, good networkers and people with acute political awareness and skills

What are the skills needed for collaborative leaders? Being able to construct and articulate visions Being able to demonstrate community leadership – focused on

the broader perspective Having influencing skills – not reliant on formal position and

status in organisation – not positional power

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Possessing personal attributes such as trust, integrity and not being underhand

Having an ability to challenge effectively and sensitively Having good negotiation skills to bring people with you Possessing a sound knowledge base to promote credibility with

partners – knowledge of issues and being well versed in the subject matter earns respect

Having an ability to link strategy with delivery and appreciate the links and implementation structure necessary to convert policy into practice

horizon scanning skills networking skills ability to value other people’s contributions being able to articulate what benefits accrue to each partner proficient in change management skills facilitating rather than chairing meetings having energy, drive and reliance promoting respect for everyone being flexible in approach Partnerships are not self perpetuating and need careful

nurturing. They need to be sustained; it is important to arrange regular feedback from partnerships and to be able to “take the temperature”; it is particularly important to deal with anti-partnership behaviours (outside meetings) and to reward/incentivise re-enforcing positive behaviours; diplomacy is important – sorting things outside partnership meetings – taking people to one side – being a coach and mentor – and this needs emotional intelligence which involves understanding and influencing people’s behaviours

Language is very important in formal meetings – if it aggressive or dismissive it can be destructive

“Partnership is not for novices or just for Xmas!”

KEY POINTS FROM THE DISCUSSION IN SOUTH WALES

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Leadership for Collaboration should take as its starting point the needs of users and citizens; the end result and outcomes are the most important focus not the convenience/administrative arrangements of single organisations

Is leadership for collaboration different from leadership in single organisations? One argument advanced was that, within organisations, there are still very powerful interest groups (clinical and consultant staff) and that it not practical to work in a hierarchical fashion; a collaborative approach is the only realistic strategy when faced with powerful departmental and professional baronies and fiefdoms, so that this is not much different from working between organisations; the skills needed are the same, although understanding the ‘knowledge base’ of other organisations may be different. A command/control model is a poor approach – it is important to change behaviour and culture through persuasion and enforcement strategies only ‘stick’ for a week. Another view was that although collaborative models could be used within organisations, there was no alternative to sharing power in inter-agency settings because of the dispersed nature of power relationships

Leadership must be flexible and different approaches are necessary depending upon the task and environment. Leadership approaches may go through different phases beginning with a predominantly controlling approach at the start and moving to coaching and delegation as the process unfolds

One of the main problem of partnerships is the general lack of clarity around purpose and the consequent difficulty of holding people to account; people have to give up power and trust partners ; it is important to understand where each partner is coming from and to have the confidence of shifting positions and ‘letting go’; there is a need to empathise with others and appreciate the flexible way in which others frame the world

Can you be both a leader and a stakeholder? It is important that everyone is a stakeholder in a partnership but that each partner achieves ‘gains’ – however, there are compromises that leaders must make.

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Competencies for collaboration? These include visioning, integrity, drive and promoting collaborative values and the ‘common good’; relationship building is key as are facilitation skills and consensus building; leaders need to set out the ‘rules of the game’ for collaboration. One view is that there are no specific skills necessary for leading in collaborative contexts – that leaders need a toolbox of generic skills which they apply as necessary – although some may be emphasised more than others in collaboration.

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BACKGROUNDThe emergence of theories and research on collaborative leadership comes at a time when an increasing focus, particularly in the USA, is being given to notions of ‘collaborative governance’ defined broadly as “some amalgam of public, private, and civil-society organizations engaged in some joint effort (Donahue, 2006:2) and ‘collaborative public management’, defined as “a concept that describes the process of facilitating and operating in multiorganizational arrangements in order to remedy problems that cannot be solved – or solved easily – by single organizations” (McGuire (2006:33). Cooper et al (2006) extend the latter notion to one of ‘citizen-centred collaborative public management’ to emphasise the role of the public in these processes. Although questions can be raised as to how recent a phenomena this form of management is, there is little doubt that societal changes in terms of diversity, dispersed power, the growth of networks, permeability of structures and processes and the nature of complex issues, are primary determinants of collaborative public management.

The consequence of identifying collaborative public management as different from managing within a single organisational hierarchical setting is that the requisite skills are also liable to be different – an argument that is supported by a number of academics (Agranoff and McGuire, 2001; O’Toole, 1996; Goldsmith and Eggers, 2004; Kickert et al, 1997). This differentiation naturally raises the central question of what form of leadership is most appropriate and effective for a collaborative public management context. An emerging literature that reflects the context of collaboration can, arguably, be viewed as a new contribution to existing leadership theories. Examples of this new body of literature are Luke (1998), Lipman-Blumen (1996),

A SHORT LITERATURE REVIEW ON LEADERSHIP FOR COLLABORATION

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Saint-Onge and Armstrong (2004), Linden (2002) and Alexander et al (2001)

Luke (1998) introduces the concept of catalytic leadership for interorganisational settings which require leaders to have certain foundational skills. Firstly, an ability to think and act strategically, involving systemic thinking to reveal interconnections and strategic leverage points, to frame and re-frame issues, to define outcomes, and to assess stakeholder interests. Secondly, the need for interpersonal skills to facilitate a productive working group or network, requiring the application of facilitation, negotiation and mediation skills, and lastly, the need for an underlying character which is not synonymous with personality, but is evidenced by a passion for results, a sense of connectedness and relatedness, exemplary personal integrity and strong ethical conduct.

Lipman-Blumen (1996) takes up the challenge of devising a new approach for leadership to reflect the tensions between two antithetical forces – interdependence and diversity. She argues that: “the individualistic, competitive, charismatic leadership strategies, whelped on the American frontier, will no longer work. The ego-driven, manipulative, Machiavellian leadership style won’t suffice either” (Lipman-Blumen, 1996: xiii). Hence, the need for the ‘connective leadership’ model which is based on three general categories or sets of behaviours used by individuals to achieve their objectives – a direct set, which is closely related to various forms of diversity and prompt expressions of individualism, a relational set, which emphasises identification with others, and an instrumental set, which provides a source of ethically rooted action to harmonise the contradictory forces of diversity and interdependence. Each set encompasses three styles which results in a complement of nine achieving styles, and “connective leaders use the full palette of connective leadership styles in various combinations” (Lipman-Blumen, 1996: 119). The metaphor of a highly networked society is further reflected in Saint-Onge and Armstrong’s (2004) notion of a ‘conductive’ organisation where leadership is considered to be a

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critical component of its structural capital - a core competency expressed by leaders through five main capabilities – detecting patterns, responding with speed, creating partnerships, generating capabilities and infusing meaning.

Linden (2002) refers to the concept of collaborative leadership and sees this expressed through four qualities in collaborative leaders – being resolute, focused and driven especially about collaboration; having a strong but measured ego; being inclusive and preferring to ‘pull’ rather than ‘push’; and finally, having a collaborative mind-set which focuses on seeing connections to something larger. The challenge for the collaborative leader is to apply these qualities to key tasks which essentially focus on the process of collaboration including, helping to identify shared purposes, demonstrating a desire to search for shared solutions, identifying the right people, highlighting the importance of an open and credible process founded on trust, and championing initiatives.

Alexander et al (2001) outline a case for collaborative leadership within the setting of community health partnerships which “possesses distinctive characteristics that call for a type of leadership (and that produce leadership dilemmas) unrecognised or rarely discussed in the collaborative leadership literature” (Alexander et al, 2001: 160). The authors clearly differentiate between leadership within traditional organisations linked to formal hierarchical authority, and leadership in partnerships where even formally designated leaders only hold tenuous authority. Collaborative leadership is viewed in terms of five distinctive leadership themes – systems thinking, vision-based leadership, collateral leadership (which is not quite the same as distributed leadership because broad-based leadership supports, but does not substitute for, leadership expressed by formally designated leaders), power sharing, and process-based leadership.

Allen et al (1998) consider that their model of ‘collaborative/reciprocal’ leadership falls under the general umbrella

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of the new leadership paradigm involving a fundamental change in the practice of leadership, both transforming the role of ‘followers’ and revolutionising the design of organisations. Their model is the means by which these changes can be achieved through set of underpinning principles designed to empower people, promote creativity, and encourage shared vision, values and ownership. This form of leadership shifts the role of formal leaders to “that of facilitators, supporters, consultants, and sometimes teachers” (Allen et al, 1998:580). The importance of Allen et al’s (1998) collaborative/reciprocal model of leadership for the present discussion is that it is not necessarily designed solely for inter-organisational settings but is considered to be a general antidote to models that reflect hierarchical frameworks.

The need for leadership approaches to reflect settings characterised by diversity, interdependence, ambiguity and uncertainty – and this may include both intra and inter-organisational situations - may usefully be informed by recent developments in complexity theory. Marion and Uhl-Bien (2002) apply complexity thinking to propose the notion of ‘complex leadership’ based on the application of five core leadership roles as follows:

Fostering network construction: here leaders learn to manage and develop networks and cultivate interdependencies both inside and outside an organisation

Catalyzing bottom-up network construction: through delegation, encouragement and providing resources to subordinates, encouraging networks and empowering workers to problem solve themselves

Becoming leadership ‘tags’: providing a symbol, ideal or flag around which others rally around

Dropping seeds of emergence: by encouraging creativity, experimentation and innovation

Thinking systematically: encouraging an appreciation of the ‘bigger picture’.

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Complex leadership is aimed “at creating conditions that enable the interactions through which the behaviours and direction of organisational systems emerge; Leaders provide control by influencing organisational behaviour through managing networks and their interactions” Marion and Uhl-Bien (2002: 406).

This comparatively new literature on collaborative leadership builds upon previous work by key academics such Chrislip and Larson (1994), Feyerherm (1994), Gray (1989) and Crosby and Bryson (2005a and 2005b). Chrislip and Larson (1994) use the term ‘collaborative leadership’ to describe a form of leadership that they consider is necessary to be effective in contexts where public policy issues are complex and ambiguous and where particular efforts are needed to negotiate a ‘broader good’ amongst competing parochial interests. The authors highlight an important connection between problem type and leadership focus and argue that collaborative leadership needs to be based on four principles: inspiring commitment and action, leading as a peer problem solver; building broad-based involvement, and sustaining hope and participation. The leadership approach majors on the process and the leadership role “is to convene, energize, facilitate, and sustain this process” (Chrislip and Larson, 1994:146).

Crosby and Bryson (2005a and 2005b) have been advocating their distinctive approach to collaborative leadership for over a decade as a means of “developing regimes of mutual gain”. They promote a leadership framework which articulates visionary, political and ethical dimensions, and which is influenced by work on policy entrepreneurship, advocacy coalitions and agenda-setting. The framework is grounded in the realities of an interdependent world of diverse stakeholders and shared power arrangements; emphasises the widespread use of deliberative forums to share meanings, resolve conflicts and negotiate the best way forward; highlights the importance of an integrated approach to strategic management and policy change; and promotes the exercise of eight main leadership capabilities

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Feyerherm (1994) explores three leadership behaviours that are most likely to result in convergence between different groups working within interorganisational systems. Firstly, surfacing or illuminating assumptions and beliefs referring to either one’s own or others interpretations to create more information about different views and to extend the possibilities for joint action. However, surfacing assumptions does not necessarily mean that changes will occur in interpretive schemes. Secondly, creating alternatives involving problem-solving behaviours coupled with supporting, bridging and facilitating particularly to generate new frameworks and social consensus. Lastly, initiating collective action to form structures and develop and present proposals. This research emphasises the importance of leaders as managers of meaning who are “conceptualizers, providers of reasoning and context, facilitators, and profound questioners” (Feyerherm, 1994:268). It also challenges the view that leadership is a property centred in one person rather than been dispersed amongst a wider set of members.

KEY REFERENCESChrislip, D.D. and Larson, C.E. (1994) Collaborative Leadership San Francisco: Jossey Bass

Crosby, B.C. and Bryson, J.M. (2005 a) Leadership for the Common Good: Tackling Public Problems in a Shared-Power World San Francisco: Jossey Bass

Crosby, B.C. and Bryson, J.M. (2005 b) “A Leadership Framework for Cross Sector Collaboration”, Public Management Review, Vol 7 Issue 2, pp177-201

Lipman-Blumen, J. (1996) The Connective Edge: Leading in an Interdependent World San Francisco: Jossey Bass

Luke, J.S. (1998) Catalytic Leadership: Strategies for an Interconnected World San Francisco: Jossey Bass

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Agranoff, R. and McGuire, M. (2003) Collaborative Public Management: New strategies for local governments Washington, D.C: Georgetown University Press

Alexander, J.A. Comfort, M.E. Weiner, B.J. and Bogue, R. (2001) “Leadership in Collaborative Community Health Partnerships”, Nonprofit Management and Leadership, Vol. 12 No. 2 pp. 159-175

Allen, K.E. Bordas, J. Hickman, G.R. Matusak, L.R. Sorenson, G.J. and Whit mire, K.J. (1998) “Leadership in the 21st Century”, in Hickman, G.R. (ed) Leading Organizations: Perspectives for a New Era London: Sage

Bryson, J.M. and Crosby, B.C. (2006) “The Design and Implementation of Cross-Sector Collaborations: Propositions from the Literature”, Public Administration Review, December Special Issue, pp. 44-55

Feyerherm, A.E. (1994) “Leadership in Collaboration: A Longitudinal Study of Two Interorganizational Rule-Making Groups”, Leadership Quarterly, Vol. 5 No ¾ pp. 253-270

Gray, B. (1989) Collaborating San Francisco: Jossey-BassNetworks London: Sage

Linden, R.M. (2002) Working Across Boundaries: Making collaboration work in Government and Nonprofit Organizations San Francisco: Jossey Bass

Marion, R. and Uhl-Bien, M. (2001) “Leadership in complex organizations”, Leadership Quarterly, Vol. 12 pp. 389-418

Morse, R.S. (2008) “Developing Public Leaders in an Age of Collaborative Governance”, in Morse, R.S. and Buss, T.E. (eds) Innovations in Public Leadership Development New York: M.E.Sharpe

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Saint-Onge, H. and Armstrong, C. (2004) The Conductive Organization: Building Beyond Sustainability Oxford: Elsevier Butterworth-Heinemann

Van Wart, M. (2008) Leadership in Public Organizations New York: M.E.Sharpe

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People and organisations collaborate for a number of reasons including both voluntary and mandated reasons:

They want to because they are driven by altruistic reasons connected with public service ideals, citizen centred and client-focussed services

They need to in order to access/share resources with other organisations (finance, learning, power), improve efficiency, reduce duplication and promote better co-ordination

They have to because of government mandate and exhortation Partnerships are often represented by people with different and

sometimes conflicting motivations Individuals can have more than one motivation at any one time Motivations are dynamic and can alter as a result of the

experience of that partnership and/or changing environmental circumstances and context

The key question is how much clarity and consensus is needed at the outset to move forward?

In Wales, there is a great deal of mandated collaboration and this is set out in legislation and re-enforced by Ministers; legislation does express high level commitment to the need to collaborate – it is an important message – you need this to be

CLARITY OF PURPOSE

DISCUSSION QUESTIONS How important is it to achieve clarity of purpose

between different partners with different aims and purposes?

Is absolute clarity vital from the start of partnerships or are broad aims sufficient to provide direction for collective action?

How important is it to operationise complex and high level notions such as ‘integration’?

Is an emergent rather than a planned approach to strategy development the most effective? KEY POINTS FROM THE DISCUSSION IN NORTH

WALES

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highlighted to prevent organisations from drifting back to their default positions which involve self-interest and getting on with their own objectives such as waiting times and targets.

WAG needs to practice what it preaches – Ministers need to work at both strategic and operational levels and different departments of WAG need to co-ordinate more effectively – there are too many strategies coming out of different parts of WAG!

There is the problem of lack of synchronicity between different motivations between organisations – these are dynamic and influenced by different government imperatives – targets, resource availability

Purpose is connected to ‘accountability’ – this is usually single – there is too much focus of individual organisational accountability and not enough around developing forms of collective accountability

How important is it to have the same purpose? What level of tolerance is necessary to work with different motivations and purposes and how can you manage this situation? At a very basic level, different interpretations and meanings are often ascribed to collaboration which confuses expressions of purpose. One way of seeking to promote clarity around meaning is to envisage collaboration as consisting of different forms based on weak to strong forms of relationships and interaction. At the lowest level is a situation of fragmentation and separatism between organisations which is a highly dysfunctional and inefficient ways of organising services. This can be addressed by organisations getting together to co-operate on certain activities and concerns that they share in common leading to information exchange, joint discussions and joint learning. This may lead to a more intense state of interaction that is referred to as co-ordination where individual organisations retain control over their particular activities but aim to avoid duplication and overlaps in service and ensure a better co-ordination of activities. Further along the spectrum are forms of collective activity that are variously termed ‘collaboration’, ‘co-production’ or ‘integration’ Here, the intention is that different organisations come together to jointly

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design and deliver public services and power and control leak from single organisations. A final manifestation of this process involves the mergers of organisations (or parts thereof) to create a new, autonomous organisation – in other words, a merger. It is likely that partnerships will not be able to leapfrog the various stages of this process as each preceding one is an important precursor to the next. Also, it may be that some people and organisations have no intention of moving along this continuum to the end and are content with weaker forms of inter-organisational relationships.

It is easy to buy into high level compelling visions – they are often vague and over–arching, but you can still have different expectations and purposes within them and some can be in conflict!

At what point in the partnership process is it best to discuss individual purposes, values and expectations? Can you operate with levels of ignorance about each other’s aims? It is important at the outset to clarify areas of interdependence between organisations – this will be the basis for inter-agency discussion – particularly in terms of how one agency’s activities impinge on another’s and vice versa.

It is difficult to be completely open at the start of a partnership process – there is a need to build up trust as a precursor to being more open and transparent – it takes a long time to get to know each other; outcomes take a long time to deliver and partnerships are lengthy and complex

The process of gaining clarity of purpose involves identifying outcomes (Health Social Care and Well Being strategies are very poor at this); lack of clarity of purpose is particularly problematical at the delivery stage where partners can claim different understandings! – notions such as ‘partnership’, ‘integration’, ‘locality models’ mean different things to different people. Can you achieve common understandings – even if they

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are different? There can be a difference between how you set out to achieve a common purpose e.g integration

Emergent and crafted strategies are more appropriate than prescriptive and overly planned exercises – this values learning, risk taking and experimentation – learning by doing – helps people understand the implication of ‘purpose’

Do we involve citizens and service users in deliberations over ‘purpose’? – problems of overly complicated language and jargon and poor communication/involvement methodologies – ‘people’ are manifested in different ways and we need multiple mechanisms to involve them effectively – problem of articulate users going native – engagement is often too high and not grounded

Conclusion: it is still desirable to search for as much common purpose as possible from the start – even to understand where ‘differences’ do occur and to see how these can be managed through the process

Clear and common purpose is very importantcommitment and sign-up; this should take the form of a simple message with not too much detail and one that is “immune from too much dilution through interpretation”; common purpose keeps people on track although there is often a problem with the blandness of visions

There is often a problem of converting grand strategies and visions into effective working on the ground – strategies should be organic to reflect good collaborative working in practice which operate despite unhelpful structures, systems and frameworks; visions can be agreed but how to move forward can be the subject of fierce debate

There is a risk of formalising effective informal partnership working – the search for increased clarity and the imposition of

KEY POINTS FROM THE DISCUSSION IN SOUTH WALES

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accountability and governance arrangements can break-up and confuse existing practices and relationships and stifle innovation

There is a need for clear and single purpose statements; these must be outcome-based and focus on service users; the need for partnership working must be elaborated and understood; issues of ‘how’ and ‘who’ logically follow a clear exposition of purpose

It is possible to ‘muddle –through’, not knowing quite where you are going and taking an opportunistic approach; ad hoc funding initiatives often promote this approach

There are particular problems at a political level with clarity of purpose; short term imperatives and changes in political control can be difficult to manage if sustainable action is necessary over a longer term; and partnerships do take time to plan and deliver

Conclusion Simple messages of purpose which can be easily communicated

into the respective lexicons of different organisations Keeping faith with common purpose through strong leadership Being prepared to take risks because of the evolutionary nature

of partnership processes- the risk is to start the partnership not knowing everything about the detail in advance

Recognising the value of effective partnership working on the ground and not sabotaging existing work through over-formalisation

Timing key decisions to reflect political realities Needing to articulate short term benefits as well as longer term

aspirations

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The motivation to work in collaboration with other organisations is varied and diverse. They are generated by people and organisations – some are internal and others are rooted in broader environmental circumstances and context. Mackintosh (1992) suggests that there are three different models of partnership each having a distinctive rationale – a synergy or added value model that aims to increase value by combining the assets and powers of separate organisations; a transformation model which stresses changes in the aims and cultures of partnering organisations; and a budget enlargement model which seeks to maximise the resources that are brought to bear on complex policy or welfare problems. Primarily in the context of a business environment, Child et al (2005) argue that there are numerous motivating factors driving the formation of strategic alliances and other cooperative strategies, and refer to Kogut’s (1988) three basic motivations for their formation as; such a form represents the lowest transaction cost alternative, it enables an improved strategic position, and it affords an opportunity for organisational learning, particularly the transfer of tacit knowledge which can only be effected by people from different agencies working together. Other prominent motivations (Contractor and Lorage, 1988) include risk reduction, achievement of economies of scale or rationalisation, technological exchange, and creating a ‘value chain’ through vertical quasi-integration linking the complementary contributions of individual partners. The compatibility and transparency of motives are highly influential on the nature and success of alliances.

Oliver (1990) offers a framework that summarises the critical contingencies of relationship formation. The first is described as necessity that equates with the mandated agenda detailed above. All the others are voluntary interactions determined by either asymmetry which is the potential to exercise power or control over other organisations; reciprocity, which emphasises co-operation and

PERSPECTIVES ON MOTIVATION AND PURPOSE

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co-ordination not power and control; efficiency, particularly around reducing transaction costs; stability, to reduce environmental turbulence and uncertainty; and legitimacy, where organisations wish to improve their reputation or image. Of course, decisions to interact with other organisations can be determined by multiple contingencies, even though one particular determinant may predominate. Finally, motivations can alter over time given the experiences of joint working and changing contexts and expectations. It is clear that the compatibility and transparency of motives are a highly influential determinant on the nature and success of partnerships.

In terms of clarity of purpose, there is little dissent that partnerships are more likely to be effective if there is a strong degree of clarity about purpose, vision aims and objectives. Wilson and Charlton (1997) state that: “through a process of dialogue and discussion, the partners establish the common ground and work towards agreeing a vision and mission statement for the initiative”; Mattessich and Monsey (1992) identify purpose as one of the key factors influencing the success of a collaboration, specifically shared vision, unique purpose and concrete, attainable goals and objectives; and Snooks et al (2006) in a review of evidence concerning the effectiveness of services delivered jointly by health and social care providers highlight ‘agreement about purpose’ amongst a list of positive factors.

Huxham and Vangen (2005) suggest that: “the craving for a clear and agreed direction and the overwhelming frustrations expressed when, as is so commonly the case, this does not seem to be forthcoming are understandable”. Establishing aims is difficult because of the differing values and purposes of the parties involved, their different cultures and professional backgrounds and the varying timescales over which they expect to see rewards. The importance of clarifying aims cannot be underestimated because they provide the basis upon which different stakeholders judge the success or otherwise of any collaboration. Huxham and Vangen

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(2005) refer to the problems of both articulating and negotiating shared aims and suggest that the problems are confused by an entanglement of different types of aims – collaborative, organisational and individual. Ownership is a material factor when it comes to considering aims; in terms of content, they can relate to both substance and process, and some may be explicit while others remain unstated or hidden; and they may change over time as a consequence of changes in the external environment. Huxham and Vangen (2005) encapsulate a key tension in alternative ways of managing aims. They state that: “at one extreme, prescriptive advice would be to bring everyone’s aims into the open, clarify motivations and tie down an agreement about joint purpose. At the other extreme, it would be to gain just enough clarity and agreement on joint purpose to allow some joint action to be commenced. How to handle this dilemma in practice is a matter for managerial judgement. A common approach is to seek the common ground and get started on that basis. The principle here is that achieving early successes leads to trust between parties and that in turn lubricates the making of compromises in respect of further joint action. Even this approach, however, has the possible downside that irrevocable differences will arise at later stages when effort has already been invested. In some cases this leads to failure of the collaboration. In others it leads to some parties having to compromise more than they would have wished in order to salvage as much as they can from the investment to date. In circumstances like this it is common to hear people argue that the joint activities should have been agreed more tightly at the start” .

In terms of intervention strategies to assist the process of negotiating shared aims and purpose, Gray (2008) suggests a range of techniques and tools including, visioning, convening, problem structuring, process design, conflict-handing and internal brokering. Key individuals – boundary spanners – can often play an important role in this process (Williams, 2002).

REFERENCES

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Child, J. Faulkner, D. and Tallman, S. (2005) Cooperative Strategy: Managing Alliances, Networks and Joint Ventures Oxford: Oxford University Press

Eden, C. and Huxham, C. (2001) “The negotiation of purpose in multi-organizational collaborative groups”, Journal of Management Studies, Vol. 38 No. 3. pp. 373-391

Gray, B. (2008) “Intervening to improve inter-organizational partnerships”, in Cropper, S. Ebers, M. Huxham, C. and Smith Ring, P. (eds) The Oxford Handbook of Inter-Organizational Relations Oxford: Oxford University Press

Huxham, C. and Vangen, S. (2005) Managing to Collaborate: The theory and practice of collaborative advantage London: Routledge

Mackintosh, M. (1993) ‘Partnership: Issues of Policy and Negotiation’, Local Economy, Vol. 7 No.3, pp.210-224

Mattessich, P.W. and Monsey, B.R. (1994) Collaboration: What makes it Work. St. Paul, Minnesota: Amherst H. Wilder Foundation.

Oliver, C. (1990) “Determinants of Interorganisational Relationships: Integration and Future Directions”, Academy of Management Review, Vol. 15. No.2 pp 241-265

Snooks, H. Peconi, J. and Porter, A. (2006) An overview of the evidence concerning the effectiveness of services delivered jointly by health and social care providers and related workforce issues Cardiff: WORD

Williams, P. (2002) “The competent boundary spanner”, Public Administration, Vol. 80 No.1 pp. 103-124

Wilson, A. and Charleton, K. (1997) Making partnerships work York: JRF

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The NHS is not particularly good at defining what constitutes ‘success’; clarity of purpose is fundamental to this process; it depends on how many partners you work with – around two is relatively easy but it gets more complicated as more partners are involved.

There are different elements of success: qualitative measures are much harder than quantitative

ones e.g. staff morale rather than financial measures how do you measure ‘synergy’? Can you involve users and clients in the process? Measuring process outcomes is important – personal

relationships, social capital, quality of communication Success can be defined by different stakeholders How do we measure quality of life outcomes? How do we measure integration and seamless services?

What happens when priorities change? – the partnership process might have been ongoing for a considerable period of time but without delivering any value – then the agenda changes – can you measure the previous process?

‘Measurement’ is linked to accountability and holding organisations to account; problem of lack of ownership of

WHAT IS SUCCESS?

DISCUSSION QUESTIONS How do we measure the success/ performance of

collaborative working – in terms of outputs, process outcomes or impact on the lives of citizens and service users?

Is accountability for collaborative outcomes assessed individually or collectively?

Are there tensions between different performance management frameworks and how can these be resolved? KEY POINTS FROM THE DISCUSSION IN NORTH

WALES

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centrally driven targets; problem of competing targets; need for greater clarification of purpose

Need for partnerships to concentrate on strategic priorities – not a plethora of working groups undertaking disparate activities in a disjointed fashion and generating lots of objectives

Need to measure the partnership process as well as outcomes; problem of data sharing/ compatibility is sometimes a barrier; role for common assessment frameworks

There are significant back-up capabilities that need to be enhanced to support effective measurement – IT/ systems/ resources/ skilled researchers

Need for evidential links between interventions and outcomes

Measuring success must be linked to objectives and include measurements across the spectrum with outputs, outcomes and measures for service users and the service itself – it is possible to get consensus on what measures to use

There is a need for a better framework for determining joint outcome measures; this is not easy to construct; now for example it is possible in relation to Detox services for the NHS to deliver its targets through its Performance Management framework but for local government to fail through its particular framework; few partnerships have formal outcome frameworks; there is a need to devise ‘shared outcomes’ which represent the added value of partnership working; these can include high level quality of life measures such as life expectancy, but mapping accountability is difficult to untangle and attribute; a major obstacle in this process is the differential inspection regimes and national targets and the policing and regulation by improvement and audit agencies; we need better outcomes measures not performance indicators

There was reference made to results-based accountability which is being developed in the Children and Young People’s Partnerships using community and performance outcomes

KEY POINTS FROM THE DISCUSSION IN SOUTH WALES

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There is a clear danger that performance measures drive the wrong outcomes; simple outputs are not sophisticated enough and ‘we gravitate to what’s easiest to count’ and ignore qualitative measures; there is also a need to link strategic and operational spheres of activity

Success is constantly being evaluated and moved – expectations change and there are different notions of what constitutes success – criteria needs to be flexible and not fixed because partnership is a journey and methodologies need to reflect the effect of changing contexts

Evaluations need to be presented in a way that service users understand and users need to be involved more in the design of measurement frameworks

Conclusions There is a need for outcome based frameworks that

embrace all agencies There needs to be a changed perspective from government

regulators There is a danger of setting long-term outcomes which are

not valid after a few years because of a change in circumstances – these need to be flexible

The notion of what constitutes success varies between different stakeholders

Communication of success is important for different audiences

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The prevailing public policy imperatives of ‘evidence-based’ policy making, improved public scrutiny, accountability and transparency coupled with the efficient and effective use of public resources has raised the importance of performance and evaluation in the design and delivery of public programmes. Working in collaboration does not escape this focus; in fact the reverse is perhaps the case firstly because there is comparatively little robust evaluatory evidence of the benefits of this form of working, and secondly, where it does exist it is often somewhat equivocal and less than convincing particularly set against the time and effort that has been expended by multiple stakeholders.

There does appear to be a natural reluctance to focus on performance and evaluation as opposed to the design and delivery of services, but the situation is often confused in collaborative environments by the lack of clarity around purpose and the disparate views on what actually constitutes ‘success’. It may well be the case that ‘success’ is different for different parties and this needs to be taken into account in devising methodologies for performance management frameworks and evaluation studies. Certainly, it is sound advice to consider both these aspects at the very start of the collaborative policy making process so that purpose and aims can be linked with critical success factors and key outcome measures. Performance management and evaluation face a number of problems in general and these are often exacerbated in partnership arenas. For instance, performance management frameworks are different for different sectors – Annual Operating Framework in the NHS and Wales Programme for Improvement in local government – and with their links to various targets and other political and policy imperatives become very strong drivers in their own right. Consequently, collaborative frameworks are more difficult both to construct, and make relevant and accountable. Resources for evaluation work are often derisory and inadequate – there is a

EVALUATION IN COLLABORATION

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problem of capacity and skills within the public sector to engage in this type of activity, and there is evidence that policy makers and politicians do not in fact take much notice of research and evaluation (Davies et al, 2000)!

There has been a great deal of effort put into the science and practice of performance management in recent years, and agencies such as Wales Audit Office and others have build up a considerable body of knowledge on the design, relevance and use of performance indicators and targets. A particular problem is the over-emphasis on quantitative measures at the expense of qualitative indicators and assessments. In relation to evaluation work, there are many profound methodological, conceptual and practical difficulties associated with undertaking research on partnership initiatives. These relate to attribution, causality, displacement and sustainability. In particular, identifying the ‘synergistic effects’ of partnership working is difficult to gauge; there are the issues associated with what is being measured – outputs and/or outcomes; are these outcomes for the service users? Do they relate to the cost-effective use of resources? And what value is placed on process outcomes? – the social capital and increased collaborative capability that is created for potential deployment in the future.

There are academic and associated debates about what form evaluation should take and there are a number of methodologies to choose from (Pawson and Tilley, 1997; Williams and Sullivan, 2007)). Increasingly, given the existence of multiple interests with often different views of ‘success’, a number of current studies use stakeholder forms of evaluation (Connell and Kubisch,1998), and others even attempt to empower users by involving them in the evaluation process. REFERENCESAsthana, S. Richardson, S. and Halliday, J. (2002) “Partnership working in public policy provision: a framework for evaluation”, Social Policy and Administration, Vol 36 No 7 pp. 780-795

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Barnes, M Bauld, L Benzeval, M Judge, K Mackenzie, M and H Sullivan (2005) Building capacity for health equity, London, Routledge

Bauld, L Judge, K Barnes, M Benzeval, M MacKenzie, M and Sullivan, H (2005) ‘Promoting Social Change: The experience of Health Action Zones in England’, Journal of Social Policy, Vol. 34, No. 3, pp 427-445

Davies, H. Nutley, S. and Smith, P. (2000) What Works? Evidence-based policy and practice in public services Bristol: Policy Press

Dickinson, H. (2008) Evaluating outcomes in health and social care Bristol: Policy Press

Connell, J.P. and Kubisch, A.C. (1998) “Applying a theory of change approach to the evaluation of comprehensive community initiatives: progress, prospects and problems”, in Fulbright-Anderson et al (eds) New Approaches to Evaluating Community Initiatives, Vol. 2: Theory, Measurement and Analysis Washington, Dc: Aspen Institute

Connell, J.P. Kubisch, A.C. Schorr, L.B and C. H. Weiss eds., (1995) New Approaches to Community Initiatives: Volume 1 - Contexts, Methods and Contexts, Washington DC, Aspen Institute

Coote A., Allen J., and Woodhead D. (2004) Finding Out What Works: Building knowledge about complex community based initiatives, London, The King’s Fund.

Evans, D. and Killoran, A. (2000) “Tacking health inequalities through partnership working: learning from a realistic evaluation”, Critical Public Health, Vol. 10 pp. 125-140

Lazenbatt, A. (2002) The evaluation handbook for health professionals London: Routledge

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Ovretveit, J. (1998) Evaluating health outcomes Buckingham: Open University

Pawson, R. and Tilley, N. (1997) Realistic Evaluation London: Sage

Sanderson, I. (2000) “Evaluation in complex policy systems”, Evaluation, Vol. 6 pp. 433-454

Sullivan, H. and Stewart, M. (2006) “Who owns the theory of change?”, Evaluation, Vol. 12 No. 2 pp. 179-199

Sullivan, H. Judge, K and Sewell, K (2004) ‘In the eye of the beholder’: Perceptions of local impact in English Health Action Zones’, Social Science and Medicine, Vol. 59, pp1603-1612

Taylor, D. and Ballach, S. (2005) The Politics of Evaluation Bristol: Policy Press

Williams, P and Sullivan, H. (2007) Working in Collaboration: Learning from Theory and Practice Cardiff: NLIAH

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NAME POSITION ORGANISATION

Jan Williams Chief Executive NLIAH

Chris Davies Lead Professional Adviser SSIA

Sue Maskell Head of Children & Family Services

Conwy County Borough Council

Gwilym Roberts Strategic Development & Commissioning Manager

Conwy County Borough Council

Janette WilliamsHead of Strategic Policy

Unit Denbighshire County Council

Anne Smith Head of Nursing Vale of Glamorgan LHB

Jackie WalleyHead of Policy &

Performance Denbighshire County Council

Lynne Joannou Chief Executive Anglesey LHB

Dafydd P Lewis Strategic Director Care Gwynedd Council

Sally Baxter Chief Executive Denbighshire Local Health Board

Jane Jones Joint Strategic Commissioning Manager

Denbighshire Local Health Board

Vicky McCourt North Wales Regional Improvement Coordinator SSIA

Pauline Williams Policy & Practice Officer (Social Services)

Conwy County Borough Council

Geoff Lang Chief Executive Wrexham LHB

Sophie CawdryOccupational Therapy

Manager Denbighshire County Council

Rona Mitchell Principle Practitioner (Occupational Therapy)

Conwy County Borough Council

Lesley CotterHead Occupational

Therapist North Wales NHS Trust

Pamela Lewis Therapy Services Manager (Physiotherapist)

North West Wales NHS Trust

Breeda Worthington

Senior Service Improvement Manager NLIAH

Clare Jones Director of Development & Performance Gwynedd LHB

MASTERCLASS ATTENDANCE LIST (North Wales)

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Mary Burrows Chief Executive North Wales NHS Trust

Janet Legget-Jones

North Wales Clinical School Manager

North Wales Trust (nominated by

Martin Jones, NWW Trust)

Heather PiggotDeputy Director of

Nursing North Wales NHS Trust

Lloyd Jenkinson Associate Medical Director North West Wales Trust

Sian Harrop-Griffiths

Partnership Development Director NLIAH

Wayne Jepson Partnership Development Manager NLIAH

Neil Stevens Finance Director Conwy LHB

Barbara BaleHead of Workforce

Development & Commissioning

WAG

Janet Ellis Modernisation & Service Delivery Manager Flintshire LHB

Sue Owen Nurse Director Conwy LHB

Sheila Lyons Partnership Manager Flintshire County Council

Dr Paul WilliamsReader in Public

Management and Collaboration

UWIC

Gwen Carrington Head of Social Services Gwynedd CouncilSheila

WentworthWrexham County Borough Council

Barbara BaleHead of Workforce Development and

CommissioningWAG

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MASTERCLASS ATTENDANCE LIST (South Wales)

NAME POSITION ORGANISATIONNeil Abraham Occupational Therapy

ManagerBridgend County

CouncilChris Davies Lead Professional Adviser SSIA

Nygaire Bevan Head of Adult Services and Commissioning

Powys County Council

Barbara Bowness Associate Director Partnership Development NLIAH

Simon Burch Director of Integrated Services

Monmouthshire LHB/Monmouthshire County Council

Susan Cooper Head of Adult Social Care Bridgend County Borough Council

Andrew Cottom Acting Chief Executive Gwent Healthcare NHS Trust

Kate Crosby Integrated Service Manager, Monnow Vale

Monmouthshire LHB/ County

Council/ Gwent Health care NHS

TrustAllan Davies Performance Director Gwent Healthcare

NHS Trust

Nicola Davies Head of Health and Well Being

RCT LHB and County Borough

CouncilMyfanwy DeFriend

Project Manager – Integrated Community

Equipment ServiceCeredigion County

Council

Hilary DoverOperational Director- Intermediate care and

reablementABM University

NHS Trust

Sue Evans Joint Director/Head of Integrated Services

Torfaen LHB/County

Borough CouncilStewart

GreenwellChief Officer- Social Care

and HousingTorfaen County Borough Council

Kathy Harrington OT Team Manager Powys Social Services

Abigael Harries Corporate Director- Well Being

Bridgend County Borough Council

Sian Harrop- Partnership Development NLIAH

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Griffiths DirectorAlex Howells Planning Director Gwent Healthcare

NHS TrustWayne Jepson Partnership Development

Manager NLIAHLinda Jones Interim Service Manager Caerphilly CBC

Richard LeggettSenior Principal Officer,

Commissioning and Partnership

City and County of Swansea

Susan Morgan Nurse Director/Director of Modernisation

Bridgend County Borough Council

Martyn Palfreman Business Manager SSIA

Mervyn Thomas Interim Chief Social Services Officer

Newport City Council

Natalie Vanderlinden

Head of Speech and Language Therapy

Hywel DdA NHS Trust

Joanne Williams Service Manager – improving independence

Caerphilly County Borough Council