A recent survey by CIPFA draws attention again to the essential capability that sustainability and transformation partnerships (STPs) need: the ability to collaborate.
Why is this basic capability in such short supply? Because we have invested instead in highly accountable organisations, targeting measurable, manageable transactions. 'World class commissioning' was not collaborative but contractual. Success or failure was cashed out not in health outcomes, but in the financial outturn.
In this era, I worked with a newly created community health provider to develop aspects of their strategy. After a while, it became clear that further progress was unlikely without an equal and opposite package of support for commissioners. The two teams had, only months previously, been in the same department; but almost immediately following reorganisation, they lost the ability to collaborate.
STPs are designed to overlay a safe collaborative space onto this rigid organisational framework. But the system seems woefully to have underestimated the scale of the behavioural change implied, and the levels of investment needed to support it.
Richard Vize’s report on STPs emphasised the importance of investment in organisational development. He wrote:
“Shutting a group of people in a room and expecting trust to develop, shared ownership of problems to evolve and common solutions to emerge will almost certainly end in failure. STPs need to invest time and effort in their own organisational development (OD).”
But what are the specifics of the OD required? What are the outcomes and process that might be expected?
The starting point is that trust is a process before it is a feeling. This is good news. Because trust is a process, it can be designed as well as experienced. The kinds of change needed by STPs will take many months to implement and many years to deliver results. Withholding trust until we have the proof of the pudding is a recipe for disaster.
A trust process will set out a series of short-term, visible steps that STP partners will commit to take. These steps will be useful but may not, in themselves, be transformative. What matters is that they only make sense in the context of the evolving shared goals of the STP leadership.
"What counts is a culture of trust across organisational boundaries - not a feeling, but repeatable, reliable co-creation of value."
At the same time as these steps are agreed, the design will allow STP partners to hold each other to account. Because the steps are visible, it is immediately apparent if they have not been carried out. Partners should be clear from the outset about the consequences of not following through on their commitments.
These consequences will not be framed as sanctions. Because the agreed steps only make sense in the STP context, and are not part of normal 'organisational' behaviour, they are by definition challenging. Failing to follow through will signal not bad faith, but a lack of capability and capacity. The agreed steps act as early warning signs from partners who will struggle to fulfil their system roles. Consequences will therefore consist of interventions to help partners to deliver what they have agreed. Struggling partners receive support, not recrimination.
In some cases, the agreed steps can be very simple. One health and wellbeing board I worked with merely committed to contact between board members between meetings, in pursuit of an agreed objective.
In the medium and long term, however, what counts is not interpersonal trust between senior leaders. What counts is a culture of trust across organisational boundaries: not a feeling, but repeatable, reliable co-creation of value. Such trust is rooted in a rational expectation that partners will co-operate to realise opportunities. That expectation in turn relies on an assurance that frontline and mid-level service managers are properly supported to do this.
The first duty of senior leaders in an STP is not, therefore, to 'get along together', or even to agree a strategy. Their first duty is to change the culture and to create a permissive environment in their own organisations. Unless this change happens, junior and middle managers, rigorously performance managed against organisational objectives, will not be able to commit to realise value beyond the organisational boundary.
Early, visible measures to address the internal culture of organisations are quick, cheap and a powerful signal of good faith. Changing job descriptions, modelling and coaching collaborative behaviours, sharing space and time and fun with colleagues across the boundaries are all very achievable even in the current context.
These simple steps are the basic ingredients of OD for systems leadership. They need to be carried out intentionally and clear-sightedly, but they are not a black art and they need not be expensive. But they are essential.
Kaleidoscope. Collaboration that works. We are working with STP leaders to deploy, develop and measure a collaboration toolkit. To start to work with us, contact firstname.lastname@example.org