partnership working: does it have a future in nhsscotland?
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Does Partnership Working have a future in NHS Scotland?
Professor Nicolas BaconNottingham University
Sustaining effective partnership working requires: 1. Shared Aims2. Effective Structures3. Appropriate Behaviours
1. Shared Aims
Leading example of employee participation in the public sector due to a post-devolution consensus- SGHD works closely with Health Boards and staff representatives to improve health services through a shared commitment to coordinating services rather than market-driven reforms.
2. Effective Structures
i. Partnership at both national-level and in Health Boards- effective partnership should range from the boardroom to the ward.
ii. Separate integrative from distributive issues (SPF, SWAG and STAC)- firewall cooperation from difficult issues (National Scrutiny Group).
iii. Match structure to purpose- large meetings are inclusive and smaller meetings engage in more problem-solving.
3. Appropriate Behaviours
POSITIVE NEUTRAL NEGATIVE
Proposing Seeking information Blocking
Building Giving information Disagreeing
Including Deferring Criticising
Solidifying Empathising Attacking
Agreeing Defending Preconditions
Open Advance notice Shutting-out
Trusting Apprehension
Threat
Behaviours in three partnership committees
0%10%20%30%40%50%60%70%80%90%
100%
SPF SWAG SWAG Secretariat
Negative
Neutral
Positive
Shared aims and effective structures affect behaviours
0%10%20%30%40%50%60%70%80%90%
100%
SPF Welsh Partnership Forum
Negative
Neutral
Positive
Conclusions- sustaining effective partnership in NHS Scotland will require:
1. Maintaining a shared aim and agreement on how to address the challenges ahead.
2. Ensuring structures are appropriate to:
i. Engage staff in strategic, workforce and workplace discussionsii. Agree the aims and overall direction before the detailiii. Firewall difficult issues iv. Facilitate both inclusion and problem-solving
3. Sustaining appropriate behaviours to maintain positive relationships.
THE ROLE OF THE EMPLOYEE DIRECTOR WITHIN NHS
SCOTLAND
THE MAIN AIM OF THE STUDY
Undertake a critical evaluation of the role of the Employee Director within NHS Scotland in the context of Scottish Government policy of partnership with trade unions at a strategic board level
Background
Employee relations in NHS Scotland took a new direction in July 1999 with Scottish Governmentpolicy developing
‘Towards a New Way of Working’
DATA COLLECTION METHODS
Mixed-method approach Quantitative in the form of survey and Qualitative semi-structured interviews
RESEARCH FINDINGS Principles of Partnership
0
5
10
15
20
25
Stronglyagree
Agree Neitheragree/
disagree
Disagree Stronglydisagree
Level of Agreement/Disagreement
Co
un
t o
f R
es
po
ns
e
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
TRUST
Trust between Mgmt & Unions
02468
10121416
Stronglyagree
Agree Neitheragree/
disagree
Disagree Stronglydisagree
Level of Agreement/Disagreement
Co
un
t o
f R
es
po
ns
e
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
EXPECTATIONS
Iam not always completely clear about what is expected of me when working in partnershp
02468
101214
Strongly agree Agree Neither agree/disagree
Disagree Stronglydisagree
Level of Agreement/Disagreement
Co
un
t o
f R
esp
on
se
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
DECISION MAKING
Strategic Decision Making
0
2
4
6
8
10
12
14
No influence A little influence Some influence A lot of influence
Level of Influnce
Co
un
t o
f R
esp
on
se
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
SERVICE REDESIGN
Modernisation
0
2
4
6
8
10
12
14
No influence A little influence Some influence A lot of influence
Level of Influence
Co
un
t o
f R
esp
on
se
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
FINANCE
Financial Governance
02468
101214
Stronglyagree
Agree Neitheragree/
disagree
Disagree Stronglydisagree
Level of Agreement/Disagreement
Co
un
t o
f R
esp
on
se
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
STAFF GOVERNANCE
Staff Governance
02468
101214
Stronglyagree
Agree Neitheragree/
disagree
Disagree Stronglydisagree
Level of Agreement/Disagreement
Co
un
t o
f R
esp
on
se
Employee Directors
Executive Directors
General Managers
Others
Staff side reps
CONCLUSION
A main conclusion of this study is that, in the context of major organisational change and financial pressure, the partnership model practiced within NHS Scotland is fundamental to employee relations within health boards
RECOMMENDATIONS
There is a need to support and understand the knowledge base of the Employee Director. The development of a person specification, identifying the skills and qualification required to support of the scope and range to undertake the role. The establishment of a joint working group to identify the core skill set required will then be translated into the Employee Directors Personal Development Plan
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