Partnering is at the heart of current reforms in the NHS in England. New types of alliances are being explored to improve care and maintain quality despite pressures on budgets. These partnerships reflect the partnering arrangements being used in other sectors and countries, and build on similar assumptions about the benefits of diversification, sharing good practices and pooling resources.

This research confirms the findings from previous analyses, that while partnering does have potential benefits, these are not easy or quick to achieve. To have a meaningful impact on the quality of care, the right form of partnering needs to be used in the right context and, as we summarise in Table 2, it needs to be accompanied by the right set of enabling factors.

Table 2: Partnering types and impacts

Partnering arrangement

Main advantages

Helpful context

Key enablers

Voluntary – individual

Facilitating clinician-led improvement projects across a common pathway

Securing support from immediate teams

Introducing new practices quickly (although at small scale)

Previous positive working across the services

Organisational support for partnering in general and with the suggested partner(s)

Identified need or opportunity to improve patient care

Leads within individual services communicate well and share responsibilities

Engaging operational managers from both partners

Structuring in time for shared reflection on progress

Mainstreaming within normal processes and data capture

Mandated – individual

Provides a mentoring opportunity to share concerns and discuss potential opportunities

Relatively low cost and easy to organise without major organisational disruptions on either side

Organisation seen as requiring improvement recognises the need for change and is looking for support

Organisation seen as requiring improvement has resources required to implement changes

Individual partnering is linked to wider internal and external change programmes

Individuals in both organisations have sufficient time to meaningfully engage

Individuals in both organisations remain connected throughout the process

Prioritise and focus on key partnering opportunities rather than introducing several major changes at the same time

Mandated – structural

Enables acquiring organisation to have legitimacy and power to introduce its practices

Internal and external stakeholders understand the basis of the relationships

Acquiring organisation can shape the new entity to meet its overall strategy

Acquiring organisation is already looking for the opportunity to partner

Acquiring organisation has a strong financial position and a stable board

Regulator and commissioner are willing to provide financial support and time for the acquisition to be undertaken

Thorough communication to staff and stakeholders of both organisations

Seeking relevant data, patient experiences and staff perspectives to assess the current position

Introducing shared governance and management structures

Enabling key stakeholders to have regular updates and contribute insights

Recognise strengths within acquired organisation and avoid negative stereotyping

Voluntary – structural

More formal sharing of resources and risks

Partnering provides resources and influence to fulfil an individual organisation’s objectives

Opportunity to add value beyond fragmented organisational responses

Organisations are in strong financial positions and have stable boards

Organisations are comfortable with partnering in general

Previous positive experiences of working together through smaller scale projects

Opportunity to attract new resources to deliver shared project(s)

Dedicating sufficient resources to develop more formal and large-scale partnering

Key values of organisation are similar in relation to the project(s) in question

Opportunity for key individuals within the organisations to directly engage with their counterparts

Clear vision of what partnering will achieve with the positive support of board and executive members

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