15th November 2008
Partnership working is
alive and well – and helping our NHS save lives
The IPA often gets asked the question: what
has happened to partnership, to unions and employers working together to
deliver common goals, to the spirit that animated much of industrial relations
in the 1990s.
The answer: it is alive and kicking in many
places, not least our national health service.
The IPA has just completed a major study of social partnership working
in the NHS – and has given it a very positive endorsement. Our study found that
partnership working is helping transform relations between staff and managers,
is an important factor in the management of change and reform in the NHS and is
directly and positively impacting on service delivery at local level. It is
also providing the crucial underpinning for the increasing development of
employee engagement at trust and hospital level.
The lesson of public service reform in the
past decade is that you have to take the staff with you. Imposed change will be
resisted – owned change is much more likely to be embraced. But too often staff
felt they were treated as the obstacles to change, rather than the agents of
it. Within the NHS only sporadic
attempts were made to work positively with trade unions. Despite the existence of national partnership
machinery, too often major announcements with huge implications for staff were
made without any reference to staff organisations. Relations were fraught as a
result.
All three parties acknowledged that a major
revamp of partnership arrangements was needed, bringing together the Department
of Health, NHS Employers and health service trade unions around a common vision
of the NHS. The new partnership
agreement endorsed by ministers, employers and unions in March 2007 had at its
core a set of key principles for effective joint working, including building
trust and mutual respect, openness, honesty and transparency, top level
commitment from all three parties, early discussion and a no–surprises culture,
and a positive and constructive commitment to work with and learn from each
other.
As the then Secretary of State Patricia
Hewitt wrote in the foreword to the agreement: ‘a key factor in any successful change programme is a
commitment to engaging and involving the workforce at all levels…it is through
partnership between patients, users, managers, employees and trade unions that
organisations can innovate. The views of staff matter – staff have the
knowledge and experience to know what really works and we need to harness this
knowledge and engage the experience to help facilitate change.’
As well as the national framework set out
in the agreement – based around monthly meetings chaired by a health minister –
all sides committed to extending and developing partnership approaches at
regional and local level.
The IPA study identified some very
effective partnership project working at national level, addressing problems
such as roadblocks to skills development and graduate unemployment. There have been very positive partnership
contributions to policy development, in particular the major reform programme
the Next Stage Review, which ensured that staff and their organisations were
able to input fully at every stage of the review.
Above all our report identified the growth
of trust and joint working at national level as major achievements, ensuring
that the sixteen trade unions (including TUC affiliates and non-affiliates),
NHS Employers and the Department of Health were able to work towards common
strategic goals. Trade union and
employer contributions through the Partnership Forum strengthened policy
development and certainly improved the implementation and delivery of change.
The study found a flourishing range of
partnerships at local hospital and trust level. Many local partners stressed
the importance of partnership working in meeting challenges such as hospital
and service reconfiguration, as well as financial constraints. Others
emphasised that a partnership approach had enable staff to become engaged in
designing and developing service improvements at ward level, which impacted
very positively on patient care.
Partnership working does not mean all
parties agree; some NHS unions for example remain unconvinced about aspect of
government health policy, including the use of the private and voluntary
sectors to provide services. But it does mean that these differences can be
articulated without derailing the overall relationship.
It also provides an essential mechanism for
a timely discussion of difficult issues and for agreeing a strategic way
forward. As the consequences of the
credit crunch work their way through to public spending levels, the NHS will
face some serious challenges. The commitment to a partnership approach to
dealing with these will stand the health service in good stead in the years
ahead.
Nita Clarke
IPA Director
