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How developing principles for joint working can be a key ingredient for the success of a service delivery partnership

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This case study is part of a series looking at the role of voluntary organisations in health and social care system transformation. It was kindly supplied by Simon Kweeday of Big Life Group.

Background

In 2012 Salford Council public health team commissioned a service to support people who have multiple health behaviour issues that they want to change (such as smoking, alcohol consumption, low exercise or activity, weight problems or low mood) but did not know where to start. 

The issues we faced

This was one of the first occasions a voluntary sector partnership had won a public health contract.  We wanted all partners to come into the partnership with:

  • something to offer – a good neighbourhood footprint or an area of expertise.
  • good track record of delivering services
  • strong intelligence about the communities in which they worked and therefore how things should be done.

Many of the partners had also been partners in other bids for the same contract. It was therefore important to spend time to understand each other, each organisation’s motivations and objectives and develop an agreement for how this successful partnership would work together to meet its goals.

The actions we took

Big Life group developed a partnership to design and implement Being Well Salford’, an innovative motivational health coaching service that supported over 3,000 people to improve their lifestyle behaviours on their own terms.  The partnership consisted of six voluntary organisations together with a university, with Big Life Group as the prime contractor.

We had six months to design and develop the service after contract award and the initial part of this was allocated to partnership development.  As part of this process we:

  • agreed a set of principles and values for the partnership based on each partner’s values, beliefs and motivations.  This ‘document’ was visible in each meeting we had and was refereed to when challenging situations developed 
  • set up a partnership board, with a seat for each partner, that met regularly to review progress of the service, analysing data, suggesting solutions to issues and offer a challenge to strategic and operational developments, For example:
    • We discussed and agreed which decisions would be made collectively, and which would be held by the prime contractor.
    • We agreed on a process for how we would overcome disagreements.
    • We discussed expectations and added our collective agreed expectations to the joint working agreement, including frequency of meetings, how we would communicate, timing of responses.
    • We co-produced all elements of the service, including recruitment process, allocation of staff, neighbourhood working approaches, training, caseload management and key areas of responsibility.
    • set up task and finish groups (e.g.  training and development, recruitment and selection, evaluation group, operational group) and asked different partners to lead on them, providing shared control and diversity of approaches. 
    • invested in an external evaluation of the partnership and learnt a lot about what was working, why and what could be done differently. 

Positive outcomes

  • Being Well Salford supported over 3,000 people to improve their lifestyles and reduce unhealthy behaviours, that have been sustained over time.  The service and partnership has enabled the approach to replicated in other areas by both Big Life group and partner organisations, with many adapting the coaching model through other contracts.  Some organisations in the partnership had other opportunities to work together elsewhere and the relationships we developed together continue to be strong. 
  • Our approach to working co-productively with commissioners, enabled us to be agile and flexible in making necessary changes mid-service.
  • Being Well Salford achieved local and national awards, including the Royal Society of Public Health 3-year award for innovation in public health services and the Public Health ministers award.  BWS was also used as an example of good practice in NHS England’s national programme, Realising the Value.

Negative outcomes

The staffing model, where staff where employed by different organisations, was at first problematic, as staff in the same role had different terms and conditions.  While salary was consistent, other benefits, such as pension contribution, was different and this caused issues amongst the team. 

Some partners felt that while we were agile and efficient some decisions through the collaborative decision-making process took longer to make. 

It takes time and resource to develop and mobilise a partnership and service.  When this is done by the third sector, who generally work towards good social value principles, including supporting local employment and using local supply chains, the impact of short-term commissioning influences sustainability of expertise within those services.

Lessons learnt

We believe the time taken at the start of this partnership to develop the vision, values and principles of joint working enabled us to work together effectively. The process wasn’t always easy, there were some tricky issues to address but it was worth it. We referred back to the documents a number of times when issues arose, and this helped facilitate a smooth process for overcoming them and developing solutions. We have been part of other public service partnerships that haven’t gone through this process and conflict and competition have got in the way of achieving the vision.

Our advice to providers and prime contractors:

  • Involve people as early as possible.
  • Be prepared to change.  Often we want change but don’t want to change ourselves.
  • Be honest and share truths no matter how uncomfortable.
  • Don’t agree to do something you can’t deliver.
  • Ensure the partnership is stronger together and has complementary strengths.
  • Don’t choose partners just to follow funding, or if their interests conflict with your own.
  • Put things in writing.
  • Review the partnership on regular basis. 
  • Communicate any issues that will impact on them (e.g. invoicing, changes in staff).
  • Have fun! Otherwise its boring.  
  • Allow plenty of time in the commissioning process for a partnership to form, co-design a service and bid collectively.
  • Build social value into the procurement and build local assets prior to procurement. Think about longer term commissioning to protect voluntary organisations

Our advice to commissioners:

  • Allow plenty of time in the commissioning process for a partnership to form, co-design a service and bid collectively.
  • Build social value into the procurement and build local assets prior to procurement. Think about longer term commissioning to protect voluntary organisations.

Further information

Being Well Salford one-year evaluation

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Page last edited Sep 19, 2019

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