Building Health Partnerships

Institute for Voluntary Action Research and Social Enterprise UK (originally posted March 2015)

The Building Health Partnerships Programme (BHP) works to improve local health and wellbeing outcomes, through supporting the development of effective and productive partnerships between Clinical Commissioning Groups (CCGs), local authorities and voluntary, community and social enterprise (VCSE) organisations.

The Health and Social Value programme (H&SVP) is specifically designed to support local areas to deliver and commission for social value in health and care.

The programmes are funded by NHS England and Department of Health respectively, and delivered in partnership by the Institute for Voluntary Action Research (IVAR) and Social Enterprise UK (SEUK). This short briefing paper is based on key learning and outcomes from the first phase of both programmes.

1.Cumulative insights into critical success factors/conditions for productive cross-sector partnership

We are committed to finding ways in which partnership working between public agencies and VCSE organisations can be improved through a joint approach to the practical problems raised by the multiple pressures for cross-sector collaboration.

Through both programmes we have quite deliberately used the IVAR/SEUK action learning method to focus on cross-sectoral collaboration rather than looking at collaboration from the separate viewpoints of the two sectors. Since the spring of 2013 the Building Health Partnerships and Health & Social Value programmes have observed and reported on a number of key areas that have proved to be critical in ensuring successful cross sector partnership delivery towards improving local health and well-being outcomes. These include:

A readiness for change and challenge

The importance of practitioners having an appetite for doing things differently; and the value of seeing change as a process, rather than an event, allowing relationships to be built over time, and ideas to be translated into practical action and tangible outcomes.

Leadership and senior level engagement throughout

Linked to the importance of relationship building is the active involvement of senior staff and the concentration of effort and attention on getting things done together.

A high level of support

Bespoke facilitation with access to experts and resources is critical, both to help negotiate and moderate differences, as well as provide an independent perspective on priorities.

Getting to grips with the VCSE offer locally

For CCGs, BHP has provided the opportunity to get to grips with the potential role and contribution of VCSE organisations in improving health and wellbeing. More specifically, BHP has helped CCGs to focus attention on specific areas of development that can benefit from more active involvement of VCSE organisations.

A specific health focus

Assembling local resources around a specific, locally identified priority area of health has enabled the value of local assets and expertise to be recognised and harnessed.

A pilot approach

Testing new approaches, within a facilitated learning environment, provides a foundation for learning and opportunities for replication.

Partnerships with new people

An emphasis on building cross-sectoral solutions to shared concerns allows for surprising friends and allies to come together and form new relationships.

Building levels of trust, mutual respect and closer understanding of the other’s sector working environment has been the common thread running through the two programmes. As a result, relationships are now closer, sharper and clearer, especially around the identification of shared priorities and joint action.

In September 2013, IVAR and SEUK interviewed representatives (senior staff or board members) of the CCGs involved in BHP Phase One and more than 75% of survey respondents said that BHP had contributed to the CCG being able to identify practical solutions to improving health and well-being outcomes and had helped the CCG feel more confident about cross-sector approaches to improving those outcomes.

2. The partnership improvement support model

Starting with the Expression of Interest/Application stage, participating areas in both programmes are asked to evidence their current and intended involvement of senior cross sector engagement.

Each learning site receives a bespoke programme of facilitated support, with up to 30 senior leaders from the CCG, local authority and VCSE organisations in each area taking part.  The core sessions include the following:

  • Diagnostic session to create a shared understanding of the national and local health policy context
  • An expert seminar to tackle specific local needs and build local knowledge
  • Implementation sessions to embed learning and review delivery of action plans
  • Additional bespoke support and facilitation from a dedicated facilitator at and between events.

A series of national sessions also support the delivery of the programmes, offering opportunities for the learning sites to come together with other areas and share their experience and developing expertise.

3. Practical examples of how that approach has translated into tangible outcomes locally

As health/care commissioning and procurement at a local level increasingly becomes a cross-agency, cross-sector exercise, the need to deliver tangible outcomes and action through partnership also increases.  The IVAR/SEUK approach to supporting cross-sector partnership working in health BHP provides the capacity and focus to do this, bringing providers and commissioners together in a neutral space, and helps to build a network of practice and experience to share for the challenges ahead.

Tangible outcomes across the 16 learning sites involved in phase one of the two programmes include:

Systems and structures

  • VCSE as part of the local Integration Executive strategy and initiatives to integrate health and social care (Swindon)
  • New social impact CRM tool for customers, commissioners and providers (Dudley)
  • CCG investment in local infrastructure in the form of Locality Link Workers around GP practices including a VCSE role in multi-disciplinary teams (Dudley)
  • New commissioning model around meeting the needs of the elderly/isolated (South East Staffordshire and Seisdon Peninsula)
  • The development and implementation of a Social Value Procurement Framework (Halton)
  • Re-commissioning mental health services with VCSE engagement (Bristol)
  • Engagement of BME community in services development around diabetes (Bristol)
  • Cross sector approach to commissioning and procuring for social value underlined by the Marmot principles (Halton)
  • Social Value at the heart of the City Partnership endorsing cross sector social value commissioning (Salford).

Working practices

  • Cross-sector teams rolling-out Social Prescribing approaches across GP surgery clusters (Hackney/Dudley/Durham/Swindon/Wakefield)
  • VCSE pilots commissioned e.g. in Mental Health Support (Swindon)
  • Better VCSE support and services information available locally with advice about the care and support choices available to people (Dudley/Croydon/Hackney/Swindon)
  • VCSE strategic engagement in delivering local health outcomes and addressing the local health budget deficit (Dudley)
  • A dataset of evidence to support the health outcomes of an under-represented group (Manchester)
  • Social Value embedded in procurement practice and delivering results (Halton)
  • The development of a cross sector Social Value Charter (Salford)
  • Key projects developed as part of BHP (Community Navigators and Wellbeing Co-ordination) becoming part of the Public Service Transformation Network (Swindon).

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