Diploma in Health and Social Care Edexcel Level 5 BTEC HND William Shakespeare College Centre No 15748

Working in Partnership in Heath and Social Care .

Unit Grading To achieve a Pass Grade A pass gradeis achieved by meeting all the requirements defined in the assessment criteria for pass for each unit. To achieve a Merit Grade
Merit descriptors In order to achieve a merit the learner must: identify and apply strategies to find appropriate solutions select/design and apply appropriate methods/techniques Exemplar indicative characteristics Centres can identify and use other relevant characteristics. This should not be viewed as a tick list. The learners evidence shows for example: effective judgements have been made complex problems with more than one variable have been explored an effective approach to study and research has been applied relevant theories and techniques have been applied a range of methods and techniques have been applied a range of sources of information has been used the selection of methods and techniques/sources has been justified the design of methods/techniques has been justified complex information/data has been synthesised and processed appropriate learning methods/techniques have been applied the appropriate structure and approach has been used coherent, logical development of principles/concepts for the intended audience a range of methods of presentation have been used and technical language has been accurately used communication has taken place in familiar and unfamiliar contexts the communication is appropriate for familiar and unfamiliar audiences and appropriate media have been used.

present and communicate appropriate findings

To achieve a Merit Grade

Distinction descriptors In order to achieve a distinction the learner must: use critical reflection to evaluate own work and justify valid conclusions Exemplar indicative characteristics. Centres can identify and use other relevant characteristics. This should not be viewed as a tick list. The learners evidence shows for example: conclusions have been arrived at through synthesis of ideas and have been justified the validity of results has been evaluated using defined criteria self-criticism of approach has taken place realistic improvements have been proposed against defined characteristics for success autonomy/independence has been demonstrated substantial activities, projects or investigations have been planned, managed and organised activities have been managed the unforeseen has been accommodated the importance of interdependence has been recognised and achieved ideas have been generated and decisions taken self-evaluation has taken place convergent and lateral thinking have been applied problems have been solved innovation and creative thought have been applied receptiveness to new ideas is evident effective thinking has taken place in unfamiliar contexts.

take responsibility for managing and organising activities

demonstrate convergent/lateral/ creative thinking

Calculation of the qualification final grade Pass qualification grade Learners who achieve the minimum eligible credit value specified by the rule of combination will achieve the qualification at pass grade. Qualification grades above pass grade Learners will be awarded a merit or distinction qualification grade by the aggregation of points gained through the successful achievement of individual units. The graded section of the qualifications is based on the learners best performance in units at the level or above of the qualification to the value of 75 credits. The number of points available is dependent on the unit grade achieved and the credit size of the unit (as shown in the Points available per credit at specified unit grades table below). Qualification grades Edexcel BTEC Level 5 HND
Points range 0-74 75-149 150 Grade Pass Merit Distinction P M D

Points available per credit at specified unit grades

Pass 0

Points per credit Merit 1

Distinction 2

Examples of possible outcomes based on the best 75 credits at the level of the qualification or above.
Unit grade Pass Merit Distinction Credits achieved at each unit grade 30 30 15 Points per credit 0 1 2 Total Qualification grade Points per credit 0 1 2 Total Qualification grade Points per credit 0 0 2 Total Qualification grade Points scored 0 30 30 60 Pass Points scored 0 45 30 95 Merit Points scored 0 0 150 150 Distinction

Unit grade Pass Merit Distinction

Credits achieved at each unit grade 15 45 15

Unit grade Pass Merit Distinction

Credits achieved at each unit grade 0 0 75

Working in Partnership in Health and Social Care.

Learner Name:

Assessor Name:

Assessment plan: Learner will complete the assignments: one by one / all together

Start Date:

Target Date:

Actual Completion Date:

Unit Five. Working in Partnership in Heath and Social Care. Unit code: F/601/1576 QCF level: 5 Credit value: 15
Aim. The aim of this unit is to enable learners to develop understanding of the importance of working positively in partnership with others in health and social care. Unit abstract. Working in partnership is a key element of practice within health and social care. The concepts of power sharing, consultation and joint ways of working are essential for effective service provision. Health and social care professionals need to understand the importance of promoting autonomy with individuals. They also need to be aware of their own roles and responsibilities and how they relate to others within the sector. Learners will explore the nature of partnership on three levels. First they will examine partnerships with users of services that empower individuals to make informed decisions and encourage independence. Second they will consider partnerships between different professionals within health and social care and explore inter-agency working. Finally, they will investigate organisational partnerships and examines different ways of joint working at a strategic level. Learners will study a range of theories and research findings relating to partnership philosophies and joint working practices. Methods of promoting positive partnership working will be analysed along with relevant legislation and organisational policies and procedures. Learners will also examine strategies to improve the outcomes of partnership working for users of services, professionals and organisations. Essential requirements It is advised that this unit is delivered longitudinally over a period of one year. The ethical issues that arise in health and social care research should be discussed in detail and should encompass aspects relating to protection of participants as well as data analysis and reporting of results. Learners should also be introduced to simple statistical analyses and selection of the appropriate method for presenting continuous and discontinuous statistical information, for example in tables, charts and graphs. Although work-based experience may well generate ideas for research, any research carried out within a health or social care setting will require ethical approval from the relevant NHS strategic health authority. Any research carried out in a health or social care workplace may also depend upon the employed status of the learner in that setting. The tutor should establish early on the employment and qualification status of individual learners and any constraints on research in their place of work that may apply. Every project in which the workplace is involved should have written consent consistent with the ethical guidelines of the workplace and the tutor should check that these are fully in place before any primary research commences. The research proposal should contain detailed consideration of the ethical issues relating to the project. Evidence for learning outcome 2 should include evidence of small-scale piloting of the research tools to be used as a test for their validity and reliability. Before approving projects, the tutor will need to establish that each learner has sufficient access to suitable resources to support their project proposal. Guidance. Where you have personal experiences, you can relate to them as much as possible. Use diagrams, charts, pictures and other images where you can to help illustrate your answers.

Please use the internet as a resource but direct cut and paste will not be tolerated. You can complete the assessments section by section or as one complete package, this will be discussed and agreed with you. The spaces that you are provided in the assessment pack do not indicate the length of answer expected. NB. Your work must be referenced.

The activities in this section will demonstrate that you have met learning outcome one,understand partnership philosophies and relationships in health and social care services Activity 1
Explain what is meant by partnership working in health and social care. Working in partnership is a key element of practice within health and social care. The concepts of power sharing, consultation and joint ways of working are essential for effective service provision. Health and social care professionals need to understand the importance of promoting autonomy with individuals. They also need to be aware of their own roles and responsibilities and how they relate to others within the sector.The concepts of partnership and collaboration have become amongst the most critical themes of new Labours social policy, particularly in respect of the delivery of health and social care. Although the terms are rarely precisely defined and hence have become problematic to analyse, in most understandings successful partnerships rely upon good systems of inter-professional collaboration. Through revisiting the extensive literature on the sociology of the professions, and the nature of interprofessional working, this paper will argue that effective collaborative working within health and social care is hard to achieve, particularly in the light of the vast differences in power and culture between various occupational groupings, and the inherently competitive nature of professions jostling for territory in the same areas of activity. It suggests that these issues cannot be resolved unless they are properly understood; a rhetorical appeal to the unmitigated benefits of partnership alone will not produce more effective joint working. In addition, it notes that an appropriate role for social work in the context of partnership working has yet to be defined and proposes specific tasks and values that distinguish the social worker from other related professionals. Partnerships are fundamentally about people coming together to share a common problem or issue, and taking responsibility for doing something about it collectively. Within partnership working, people take on different levels of obligation to one another - they agree to share risks eg meeting agreed targets or jointly taking the responsibility for running an activity, club or project. One way of describing partnership working is to look at how close partners are to one another. Do they mainly:
y y y

Co-operate? Partners may share information and recognise one anothers existence. However, there is no joint planning and resources are kept separate. Co-ordinate? Partners will do some planning together and may focus on a specific project. There will be some sharing of roles and responsibilities and some shared resources and risk taking. Collaborate? Partners commit themselves to longer-term projects and make organisational changes so that there is a higher degree of shared leadership, control, resources and risk taking.

Partnership is therefore both a way of working and a form of organisation. The nearer partners are to collaboration, the more likely it is that the project will be a success Getting partners involved Partners have an enormous range of reasons for becoming involved in study support projects. It can be, very simply, something that someone or an organisation wants to do because they are passionate about it for example, photography or wood carving. It can be because a large local employer wants to put something back into the community and can see that happier and better-educated young people will enhance their business opportunities in the future. It can also be because there is a greater understanding

of how study support can motivate and raise self-esteem, or to:

y y y

enhance formal learning develop new audiences eg for theatre, music develop new participants in a local club.

However, you need to make the experience for the partner as fulfilling as possible, as a poor experience of involvement in an project will not encourage future co-operation or involvement. Finding the right partner It is important to avoid over-committing yourself or overburdening the partner/s you work with. A suitable partner needs to be someone or an organisation with whom you think you can work comfortably and productively. Look on your doorstep first - both your internal partners ie those that work within the school, families or people in the community with skills or knowledge relevant to your activity, club or project. Then engage with external partners such as your local authority, the voluntary service council and other schools who can signpost you to people or organisations that are willing to help. It is a good idea to take some time over deciding who to approach partnerships that are rushed into rarely succeed.

From your experience of Health & Social Care a describe situation that clearly demonstrate partnership working. In this identify how the philosophies regarding empowerment; independence; autonomy; respect; power sharing and making informed choices are harnessed and utilised. Also indicate how relationships with service users, professional groups and organisations are beneficial to the partnering relationship. while most people would agree that clients should participate and beinvolved in the choices that affect their lives, two more practical implications need to be sketched out. While both are closely related, the more important consequence of this shift to a problem oriented approach to health and social care is the inevitability of the disappearance of discrete professions such as nursing and social work. With the emphasis of social care and health changing to meeting local needs through local solutions, the rationale for a generic training might disappear. Moreover, professional expertise is often viewed with suspicion. It is reasonable to suggest that current models of partnership, which are organized around current professional identities, In my experience of Health & Social Care a describe situation that clearly demonstrate partnership working. I Am currently working in a care home. The care home involved in partnership with NHS.Partnership between healthcare and social services agencies has been a major theme of government policy for the last ten years and the potential for care homes to contribute signicantly to health and social care planning and provision is growing. Yet, despite this, partnership working and access to basic levels of NHS support for care home residents can often be very limited. The programme has identied the need for improved access to health and healthcare as crucial in optimising the quality of life of older people in care homes. This paper explores the current difculties that face care homes in accessing healthcare services and examines thepotential for better partnership working between care homes

And the NHS as a means of delivering better access to healthcare for residents. the Care Homes Learning Network (South West), which brought together a range of stakeholders from the NHS, social services, academic institutions and the care homes sector to discuss how best to improve partnership working. Over the last ten years, partnership between healthcare and social services agencies has been a major theme of government policy and there is growing recognition of the potential for care homes to Contribute signicantly to health and social care planning and provision. It allowed for closer partnership working between strategic health authorities (SHAs), NHS trusts, and primary care trusts (PCTs), social services, housing and transport. Subsequent policy has continued to place emphasis on joint commissioning between PCTs and local authorities and reshaping health and social care services to support better partnership working. PCTs are developing systematic programmes to review the services they commission and will have the option to purchase new models of service, including those provided by the independent sector. Care homes potentially offer a network of facilities which could work with NHS community hospitals and community health teams to offer a range of service options including clinics, day care, respite care, intermediate care, rehabilitation, specialist nursing or outpatient care for older people and those with mental health needs, learning disabilities or physical disabilities. Empowerment The practical work of the partenship programme is carried out by organisations working together in regional empowerment partnerships (REPs). There is a REP in each of the nine English regions, and they bring together a range of statutory agencies, voluntary and community organisations, networks and people who are running community empowerment activities. The REPs use their collective expertise to support local authorities, statutory agencies and community organisations to work together. This helps to give more power to communities and local people to make decisions about what happens in the areas where they live. Independence Board members work alongside the Executive Group with a focus on the delivery of agreed actions in order to promote change and improved outcomes for adults. Board members should be those within their organisation, partnership or interest group who can make work together to act as a think tank for creativity around the adults independence, care and health agenda. Autonomy Play a role in ensuring that your council and local NHS bodies have clear, expected and shared outcome objectives on all of your work. The focus on improved outcomes from integrated working can then lead to a more measured debate around the efficacy of partnerships and or organisational integra tion. Ensure that this debate goes beyond traditional health and social care structures to encompass an approach to place that includes all public services Respect This practice note aims to assist associations with meeting the Respect agenda by working in partnership with each other, local authorities, voluntary and community groups and their local GP. It contains a number of case studies that identify ways to get over the barriers that associations might face when working to tackle problems and offers practical advice as to how to get the most out of working with their partners. Power sharing "Both the employer and the union have different objectives, but you need a joint-goal that can only be

achieved by working together with equal power on both sides if you want this to work.Sometimes people are set in a particular way and have old scores to settle, and that's when it comes down to leadership at the top to control that, and ensure the balance of power doesn't move too much on either side

The activities in this section will demonstrate that you have met learning outcome two, understand how to promote positive partnership working with users of services, professionals and organisations in health and social care services . Activity 2
Research and then put into your own words a definition of Positive Partnership Working. It remains the case that greater partnership working can only be realised when there are explicit strategies and building blocks in place to facilitate effective joint working. Real commitment to greater, more effective partnership working requires leadership at the highest level within the health and social care systems. Care homes need to be valued for the role that they play in supporting the frailest sections of the population. Processes need to be put in place which actively support managers and practitioners from both healthcare and the care home sector to come together as equal partners to understand each others roles and areas of expertise, to build relationships and plan for the care of older people in the local area through the reconguration of how existing services work. Only then will it be possible to achieve positive partnership working and an improved quality of life for older people in care homes. Working in partnership is at the heart of how we do our business. We understand that to be able to achieve equality of opportunity and social justice for the people. We cannot do this on our own and we have striven in recent years to build strong partnerships with our people, employees and other service providers. The Partnership is responsible for community planning in our area. This means engaging with people and communities, listening to their views, experiences and needs, and planning our services to meet those needs. Voluntary and community groups, the public sector and other agencies are all working together to make sure that these services deliver real benefits.

Research and then identify describe two pieces of positive partnership working. In this describe how each piece relates to the following key concepts:
y y y y y y y

y y y

empowerment theories of collaborative working informed decision making information sharing confidentiality professional roles and responsibilities models of working (eg unified, coordinated, coalition and hybrid models) management structures

communication methods current inter-disciplinary and inter-agency working.

Theories of collaborative working The dening attributes of collaboration include that two or more individuals must be involved in a joint venture, typically one of an intellectual nature in which participants willingly participate in planning and decision making (Henneman et al. 1995: 104). Henneman et al. further argue that individuals consider

themselves to members of a team working towards a common goal, sharing their expertise andresponsibility for the outcome. Fundamentally, the relationship between collaborators is nonhierarchical, and shared power is based on knowledge and expertise, rather than role or title (Henneman et al. 1995). The dening attributes of collaboration can therefore be summarized as follows: Intellectual and co-operative endeavour Knowledge and expertise more important than role or title Joint venture Team working Participation in planning and decision making Non-hierarchical relationship Sharing of expertise Willingness to work together towards an agreed purpose Trust and respect in collaborators Highly connected network Low expectation of reciprocation As in the concept of partnership, the involvement of the public is central to working collaboratively. Stewart and Reutter (2001) exemplify this, citing evidence from three studies in which peers and professionals collaborated as co-leaders and partners in 21 support groups. The three studies were: survivors of myocardial infarction and their spouses; parents of children with chro conditions; and nic older women with disabilities. These three studies, however, are all contextualized around chronic illness, which might not be universally applicable. The current consensus of opinion, for example, is that clients with chronic illnesses have more insight into their conditions than professionals do. Indeed, it is signicant that many examples cited in the literature deal with chronic problems such as social care, disabilities and mental health. Management Structure Clear managerial presence and support, and a specific leader or coordinator for the partnership was also seen as instrument. Strong leadership and a multi-agency steering or management group were also identified as facilitators of effective partnerships stressed the positive role that leadership can play in multi-agency partnerships. The authors state that effective leadership and the existence of allies and champions at strategic and operational levels within all of the organisations involved will contribute to the partnerships success
Informed decision making

Partnerships, collaboration and working together need to be seen as new solutions to new problems. It may be the case that the current situation reects both a negative view of the paternalistic state, with its grand narratives of fairness and equality, and a more positive view that wants to put the client at the centre of things. Whatever the reason, and we suspect that both have played their part, partnerships and collaboration are likely to grow rather than diminish. Evidence discussed above suggests that,despite the potential barriers to partnership and collaboration, they are worthwhile pursuits.

Professional roles and responsibilities The problem with new innovative ways of working may be that they are working within the old context, where professions were discrete entities with their own body of knowledge. So while the policy context is changing to encourage collaboration and partnerships, professional regulation has been slow to catch up. In addition, many clients and potential clients still prefer the old ways of working and may be reluctant to become too involved. What seems clear, however, is that certain problems will, by their nature, be more amenable to a partnership or collaborative approach. As such, more work needs to be done so that the context can keep up with the concept.

Confidentiality Services are still separate but individual professionals from different disciplines will work together to achieve specific goals. Professionals may offer training and support to staff from other agencies, but the focus and funding of service delivery remain single agency and services are separate with little obvious coordination Current inter-disciplinary and inter-agency working Positive impacts on professionals centred mainly around multi-agency activity being rewarding and stimulating, increased knowledge and understanding of other agencies, and improved relationships and communication between agencies. Negative impacts on professionals involved in multi-agency activity focused in particular on uncertainty regarding their professional identities. There were some conflicting messages about whether multi-agency working resulted in an increase or reduced workload for the professional involved, although the evidence seemed to be weighted towards an increased workload Conduct a review of current and relevant health and social care legislation and then describe how this has an impact on partnership working.

To date, many places have adopted cross-agency decision-making and management arrangements to promote and facilitate partnership working. Barriers to effective partnership working Structural (the fragmentation of service responsibilities across and within agency boundaries). Procedural (differences in planning and budget cycles). Financial (differences in funding mechanisms and resource flows). Professional (differences in ideologies, values and professional interests). Perceived threats to status, autonomy and legitimacy. These aspects are necessary in order to formalise the sharing of decision-making powers between otherwise separately accountable organisations and their respective staff. But it is important to stress that there is no right answer in terms of what structure to adopt different solutions will suit different places. Finding a structure or model to support local services or integrated team development does not of itself ensure better outcomes for service users. Nor does it necessarily ensure better partnership working. So how can the right approach to a partnership model be adopted? Essentially what is right is what works i.e. the framework that effectively brings together decision makers at strategic, operational management and practitioner levels in a coherent needs-focused manner to ensure the most effective deployment of resources (of all kinds). Of course other aspects are important, not least how practitioners organise their time and skills with service users and how they relate to colleagues in other agencies. Overall, it may be possible to get a sense of the right approach by considering the following issues

Give examples of when positive partnership working has impacted upon: Current and relevant Partnership working sits within the wider local context. This section focuses practices on the way that partnership working contributes to meeting local strategic objectives. Strategic planning needs to support effective partnership working. Equally, planning between allied health professions services and individual schools should support effective joint working through taking a Getting it right for every child approach Agreed ways of working When companies form partnerships with their employees, they need to make sure they adhere to the honesty principle or their efforts could backfire. This is because, in many cases, the employer has far more power than the employee. Certainly there are exceptions. Highly skilled, scarce knowledge workers who are in great demand from other employers have much more power than employees whose jobs could easily be outsourced.

Statutory, voluntary and private agency practices

Local, regional and national policy documents produced by eg government departments, specialists units, voluntary agencies Risk assessment procedures

Individual statutory agencies and voluntary and community organisations have their own objectives, priorities and ways of working and are answerable to different stakeholders. Relationships between them as partners must acknowledge the respective responsibilities and accountabilities of the different agencies and organisations Recognises the value of partnership working and we encourage others to appreciate the value it brings to initiatives. Local delivery of government programmes through partnerships involving public bodies and voluntary and community groups has increased considerably and making these partnerships work effectively is now more important than ever. Partnership working is about more than individual organisations meeting together and exchanging views. In situations where the employer has the bulk of the power, especially the right to fire employees who are not so scarce or hard to replace, no true partnership is possible. If such employers describe their relationship with employees as a partnership, they need to be careful to define what they mean to avoid a cynical response. First of all, they should be honest enough to admit the power imbalance. They need to be clear about the benefits to both sides of closer collaboration. They need to be fully open to foster trust. This means being clear about the relative levels of authority both sides will have in the partnership. Otherwise, employees could deceive themselves that partnership means having a greater say in key decisions than is possible or that their positions might be secure even in an economic downturn. More cynical employees might never fully trust the employer or do their utmost because of a lack of trust

Employment practices

The report identifies two different modes of employee involvement: partnership and participation. Partnership refers to collective organisation, in which employee representatives work with management, while participation refers to modes of direct involvement and consultation in the way the work is organised and carried out.The survey found that, at workplace level, 23% of all employees indicate that

partnership committees involving management and trade unions exist, while almost 38% responded that there were arrangements for direct participation in their workplaces

Service planning procedures

Effective partnership working is built upon a clear understanding of the different roles each person has in supporting the young person. Increasing clarity and agreement about roles and responsibilities improves understanding, and leads to mutually supportive relationships. Clear remits, lines of communication and accountability characterise successful approaches to partnership working.

The activities in this section will demonstrate that you have met learning outcome three,be able to evaluate the outcomes of partnership working for users of services, professionals and organisations in health and social care services. Activity 3
By using the research that you have conducted define what is meant by positive outcomes and negative outcomes

Health care professionals strive to make all outcomes positive. The patient's participation and cooperation is essential to the success. For example, based on the diagnosis or problems presented, the health care team (which includes the patient) derives goals to treat an illness or injury, to prevent an illness or injury, or to promote wellness. Partnership positive outcomes
y y y y y y y y y y y y

Bringing different people, agencies and values together. Focusing them on some shared challenges and opportunities. Helping us to look at things holistically. Helping us to look at things from different perspectives Helping us to look at things critically. Helping us to see the need for new projects and processes. Helping us to build interdisciplinary teams to run them. Helping us to avoid building overly big structures that cannot quickly respond to change. Giving us more opportunity to be heard and perhaps to influence others. Giving us more opportunity to listen. Delegating some of the politics to more local contexts. Delegating some of the negotiation and decision-making to those who implement the decisions.

Partnership negative outcomes

y y y y y y y

Making time management difficult Tying us up in endless meetings and secondment's Distracting agencies away from delivering services Making it unclear who is accountable Giving too much decision-making power to unelected bureaucrats Forcing us to work in unfamiliar contexts Driving us to 'grab the dosh and dish out the work'.

Adding to pressures on already overburdened staff.

Moreover, policy directives are creating the imperative for organizations to work together. However, the evidence for the e ectiveness of partnerships and collaborative care arrangements are less clear (El Ansari and Phillips 2001). This may suggest that partnerships and collaboration are good in themselves, rather than more e ective at solving problems. However, there is no doubt that client problems are more complex and require new ways of working. Part of the reason for the paucity of evidence about their e ectiveness may be that they need time to be integrated with existing provision y Less repetition of service provision from different organizations. y More effective use of staff due toco-operation rather thancompetition y Demystication of health care dueto bridging of gaps between y Less dilution of activities byagencies y Less chance of agencies producingservices that are counterproductiveto each other.

y y y y y

fragmented service provision Sustained energy Cross-pollination of ideas Sharing of effort and ultimately sharing of organizational structure Barriers: Complexity of relationships Representativeness of wider public Tokenism and excessive inuence ofvocal groups Desire of individuals not to beinvolved in making decisions abouttheir care Threat to condentiality

y y y y y

Identify from your research or personal experience a positive outcome that has been achieved from partnership working for users of services (this could be improved services, empowerment, autonomy or informed decision making. A lot has been written about the theory of partnership working. However, translating theory into practice is not always easy. Partnerships can be formed between a number of individuals, agencies or organisations with a shared interest. There is usually an overarching purpose for partners to work together and a range of specific objectives. Partnerships are often formed to address specific issues and may be short or long term.
y y y y y y y y y y y

Clarity of expectations and terms of engagement Best use of time and resources Mutually supportive processes Decisions that take into account the views of different stakeholders Operating on an equal footing with other organisations Sharing of roles Understanding others priorities and constraints Discussions of differences and constructive management of conflict Getting beyond individual agendas Keeping other organisations informed and being kept informed Consistency of approach and avoidance of duplication

the benefits of partnership working There is emerging evidence about the benefits for both service users and service providers of working in partnership with other services. A partnership approach founded on co-operation and collaboration between all relevant providers will have a number of benefits for service users. These include: removal of barriers to progressing towards stabilisation / rehabilitation providing more consistent, co-ordinated and comprehensive care access to a range of training, education and employment opportunities The benefits for service providers of partnership working include the ability to: develop a 'whole person' approach manage a broader range of services which address the individual's needs develop a better understanding of others skills and develop a wider range of personal skills in dealing with clients develop a wider skill base for staff to meet more effectively the needs of individuals recognise and utilise the strengths and areas of expertise of all the partner

agencies involved make the best use of available resources by managing care of more people in a coordinated and cost effective way - including pooling resources Key principles and ingredients of a successful partnership openness, trust and honesty between partners agreed shared goals and values regular communication between partners There has been a lot of research undertaken to identify what makes a good partnership and what the barriers are to achieving effective partnership working. Some key documents are listed in the further resources section. Partnerships can work in different ways and there is no one model that can be considered to be the 'best'. There are, however, a number of ingredients which - if they are present - will facilitate successful partnership working: the aim of the partnership is agreed and understood by all the partners the partnership has clear, effective leadership the role of each partner is identified and clear to others in the partnership there is shared ownership of the partnership and the partners feel there is 'something in it for them' there are dedicated time and resources for the administration and operation of the partnership there is recognition of different organisational cultures within the partnership a supportive atmosphere exists within the partnership where suggestions, ideas and conflicts are addressed The choice of partners is important. Partnerships are often formed from existing networks or where there is a history of collaborative work between potential partners.

Identify from your research or personal experience a negative outcome that has been the result from partnership working for users of services (this could be neglect, abuse, harm, anger, miscommunication, information overload, confusion, frustration, duplication of service provision or disempowerment)
Cross-professional partnerships take a lot of effort from all of those involved. Everyone must take a considerable investment of time to build a quality working relationships that underpins effective collaboration. The risk is that sometimes this can lead to a focus on the partnership for its own sake rather than for its capacity to deliver outcomes effectively. Partnering is a mechanism for sustainable achievements; however, it is not an end in itself. There are some obstacles to partnering that need to be considered. Partnerships offer a real alternative approach to sustainable initiatives by substituting collaboration for competition. No partnership is ever easy, comfortable, secure, safe, quick or cheap. However, with a lot of good management, some good will and a little determination, cross-professional partnerships can work well and may achieve a great deal more than a single profession approach to the same issue. Above all, never forget that however tough things get, as Nigerian author, Ben Okra stated: Human beings are blessed with the necessity of transformation. A cross-professional partnership has the potential to be an excellent mechanism for sustainable transformation in healthcare. _________________________________________________________

Identify from your research or personal experience a positive outcome that has been achieved from partnership working for professionals, (this could be coordinated service provision, professional approach, clear roles and responsibilities, organised communication, avoidance of duplication, preventing mistakes or efficient use of resources). a clear view of the Trust's key partnerships, their effectiveness and the risks associated with them,

embedding evaluation of partnerships into its corporate management processes identified risks to its strategic plans and has agreed actions to mitigate these enhanced partnership accountability - internal accountability, between partners and externally to service users ensured all risks to the effectiveness/accountability and value for money of partnerships are entered onto the corporate risk register and addressed on a more timely basis included outcomes from key partnerships within its corporate performance management reporting framework demonstrated compliance with Healthcare Commission standards for co-operation with other organisations, particularly to reduce health inequalities. Identify from your research or personal experience a negative outcome that has been the result from partnership working for professionals, (this could be professional rivalry, miscommunication, time wasting or mismanagement of funding). There are some potential difficulties for partners. Misunderstanding of the reasons for the partnership and a lack of commitment to the partnership can cause barriers. Other recognised barriers are: no clear boundary between partners' responsibilities reluctance to share information and data with other partners lack of time available to commit to the partnership, particularly in the early stages misconceptions or previous negative experiences of partnership working potential conflicts in philosophies of the partners lack of training among partners on substantive issues and partnership working

Identify from your research or personal experience a positive outcome that has been achieved from partnership working for organisations, (this could be coherent approach, shared principles, comprehensive service provision, common working practices or integrated services).

The impact of partnership working is a function of a number of features of joint working, and it is possible to categorise partnerships along a number of descriptive variables membership, status, structures, leadership, agendas, and organisationalcultures. Central to these is membership, with success a function of which stakeholders are allowed to participate. Partnerships can be distinguished by whether their membership is open or closed, and also by whether their members are chosen, appointed, selected, elected or invited. Participatory groups (Joldersma 1997), and heterogeneous participatory groups in particular, are more likely to be open, thus increasing the scope for diversity and for generating wider understanding, but reducing the likelihood of agreement about aims and objectives. It is in more traditional areas of public policy responsibility, where strong and established professional groups exist, that co-operation, acceptable policy options and convergence are more likely to be evident. In newer areas of public policy - environmental protection, economic development, cultural development, the new public health for example - where professionalism is less entrenched, and where the norms and values of policy remain ambiguous, there is much more scope for open groups and participatory policy-making. Thus in many Local Agenda 21 forums or alliances there are to be found a wide range of public, private and community groups debating the nature of the appropriate environmental policy response. Debate may arise either in relation to the ends to be achieved or the means to attain them. They tend to have wide-ranging objectives which are difficult to measure because they encompass macro-level goals or because the programme of specific objectives remains unclear and is subject to on-goingnegotiation. They deal with long-standing issues of concern and attempt to address deeply rooted problems.

Identify from your research or personal experience a negative outcome that has been the result from partnership working for organisations, (this could be communication breakdown, disjointed service provision, increased costs or loss of shared purpose).

Describe how the following could be barriers to partnership working: If no link is made between the work of the partnership Lack of understanding of roles and and of its member organisations, it loses ownership and responsibilities momentum. Partners will set up parallel mechanisms, rather than adapting those that already exist, increasing bureaucracy. A lack of formal structure, accountability and clear roles and not having a formal partnership agreement will make failure twice as likely. Many partnerships are based on distant and formulaic consultation rather than active engagement. . Negative attitudes Power and hierarchy in professional and managerial relationships can stultify effective partnerships. Joint working is difficult where there are perceived status differences between individual participants or occupational groups. Some practitioners perceive threats to their professional status, autonomy and control when asked to participate in more democratic decision making. Dominant, high status professions (often reported as medics) or higher graded officers are perceived to silence others contributions and risk skewing the outcome of integrative efforts. Lack of communication the use of specialist language excludes some partners; Not supporting members in their communication within communities will result in conflicting messages; communicating selectively to a few members fuels suspicion and personal agendas. Managers and practitioners will reflect in their behaviour what they feel to be a lack of back-up from above a lack of commitment from senior managers; non-executive board members or local authority councillors with a poor grasp of the subject area, but who are nevertheless expected to lead change.

Not sharing information

Partnership Fatigue occurs when agencies are involved in large numbers of partnerships whose purposes are unclear. They will be unable to list partnerships comprehensively or name their fellow collaborators without referring to papers from meetings. New work is frequently grafted onto old partnership structures without reviewing their composition. The wrong (or insufficient) partners are involved not looking beyond health and social care, especially to housing and voluntary agencies, but also crucially to users of services and local communities.

Different priorities A lack of alignment of clinical, financial and managerial perspectives of the partnership causes barriers in making progress

Poor staff morale and poor morale from other partners particularly service user and community representatives who are unpaid and poorly recognised will impact on the ability of partnerships to be established and to continue.

Different attitudes and values The professional identity, autonomy and inter-professional mistrust of any one profession in relation to others limits understanding of other professions. Individual practitioners lack of knowledge of other professions leads to a tendency to stereotype other workers. Efforts to exchange information about respective roles, if badly handled, can simply reinforce prejudice rather than enlighten multidisciplinary teams. When threatened by organisation change, authors found that people revert to NHS, local authority or professional type and that each profession will want the other to change its organisational culture. A variety of behaviours were displayed such as the job's worth syndrome, power plays, and other manifestations of skilled incompetence. In some cases, practitioners deliberately withheld referrals on to other services which could have benefitted the service user/patient. Describe how the following could improve outcomes: Communication
. A third benefit of partnering is that there is access to more resources by drawing on the full range of technical, human, knowledge, physical and financial resources found within all professions. Dynamic new networks are established through cross-professional partnering, offering each profession better channels of engagement with the wider community and a greater capacity to influence the state and federal policy agenda. Another benefit of cross-professional partnering is that greater understanding of the values and attributes of each profession emerges through partnering, thereby building a more integrated and a more stable healthcare environment.

Information sharing

Successful cross-professional partnering recognizes the qualities and competencies of partner professions and finds new ways of harnessing these for the common good. Itfacilitates the recognition of the qualities and competencies of partner professions. The first Golden Rule is to build on shared values. This is importance because a hallmark of successful partnerships is that they are values-driven. The second Golden Rule is to be creative. Every partnership is unique and brings unlimited opportunities for creative recommendations to complex problem. The third Golden Rule is to be courageous.

Consultation
Finding innovative approaches to the challenges of sustainable changes

Negotiation

is one of the benefits of partnering. Another benefit of partnering is that there is a range of mechanisms that enables each profession to share its own specific competencies and capacities in order to achieve both common and complementary goals more effectively Successful partnerships that are can be guided by principles to hold them together. These principles should be worked out as part of the partnership-building process and agreed upon by all partners. The principles provide the foundation upon which the partnership is built, and over time, they continue to provide the cement that holds the partnership together over time. Each profession will have its own priorities and may struggle to accept the different priorities of others, but a robust discussion explaining why a particular principle matters to one or another partner may go a long way to reconciling apparent differences and to achieving compromise.

Models of empowerment

Dealing with obstacles to partnering and ensuring that agreed principles are continuously respected, constitute some of the major leadership challenges in a partnership. Other challenges are related to the day-to-day management tasks of the partnerships project and activities. Above all, the individuals operating in a partnership need to think about each other and ask themselves: Do they feel connected to a common purpose? They may also ask themselves how they feel about the partnership. Do they share a commitment to working together? Is it of paramount importance? Partnering requires the right attitude and strong commitment just as much as the right structures, skills and actions

Collective multi-agency working

In some instances there may be little or no choice about partners. It is important to be realistic about what the partnership is likely to be able to achieve in this case, and to be open about the challenges involved. No partner, including you and your profession, is perfect. What needs to be identified, is a partner that will provide as good a match as possible to enable the partnership to achieve its objectives. Essentially, the objective is to identify a potential partner that has many of the appropriate attributes and the clear potential to grow more fully into the role of partner over time

Dealing with conflict

Single health profession approaches are often short-sighted and disappointing. Working separately, different healthcare professions tend to develop activities in isolation. This results in negative competition and/or duplicating effort with accompanying waste of valuable resources. Working separately often leads to the development of a blame culture in which chaos or neglect is reflexively regarded as someone elses fault. Cross-partnering provides a new opportunity for health professions to attain impressive goals synergistically with numerous benefits.

Stakeholder analysis

Identifying or selecting an appropriate partner is a critical phase of Tennysons (2003) model in relation to ensuring succ of the ess partnership. It is worthwhile to take time and locate as much information as possible about the potential partner in order to arrive

at an appropriate decision, including undertaking research to confirm the potential partners track record. This can be done by reading the potential partners web-site, undertaking a factfinding visit and / or asking others who know of the partners history for their views. There may also be some value in special activities such as workshops, site visits, and exchanges between several members of the potential partners organization. These activities will allow the exploration of the idea of partnering more fully and collaboratively before any firm commitments are agreed. Furthermore, it is a good idea to allocate some follow-up work to assess the potential partners capacity to actually turn a verbal commitment into action.

References

 Bassett, K. (1993). Partnerships, Business Elites and Urban Politics: New Forms of Governance in a

 Bauld, L., Judge, K., Lawson, L., Mackenzie, M., Mackinnon, J. and Truman, J. (2001) Health Actio Zones in Transition: Progress in 2000. Glasgow: University of Glasgow.

 Bauld, L., Judge, K., Lawson, L., Mackenzie, M., Mackinnon, J. and Truman, J. (2001) Heal th Acti Zones in Transition: Progress in 2000. Glasgow: University of Glasgow.  Department of the Environment, Transport and the Regions (2000a) Joining It Up Locally Report o Policy Action Team 17 DETR London.  Department of the Environment, Transport and the Regions (2001a) Local Strategic Partnerships: government guidance March 2001.  Department of Transport, Local Government and the Regions (2001b) Accreditation Guidance for Local Strategic Partnerships Neighbourhood Renewal Unit October 2001.  Department of Transport, Local Government and the Regions (2002) Collaboration and Co-ordinati  DiGaetano A. and Klemanski J.S. (1999) Power and City Governance Minneapolis: Univ. of Minne Press.  Geddes M. (1997) Partnership against poverty and exclusion; local regeneration strategies and  excluded communities in the UK. Bristol: The Policy Press  Granovetter (1985) Economic Action and Social Structrure : The Problem of Embeddedness American Journal of Sociology 91.3.

 Gray B. (1996) Cross Sectoral Partners: Collaborative Alliances among Business, Government and Collaborative  Edwards K Partnership in Mental Health Care (Churchill Livingstone, 2004)  Glasby J and Peck E (Editors) Care Trusts: Partnership Working in Action (Radcliffe  Medical Press, 2003)  Morris J Community Care, Working In Partnership With Service Users (Venture Press,  1997

1. http://www.google.co.uk/search?source=ig&hl=en&rlz=1G1SVEE_ENUK439&=&q=working+par sx10&aql=&oq=working+parte#sclient=psy&hl=en&rlz=1G1SVEE_ENUK439&source=hp&q=pa g1g-j1&aql=t&oq=&pbx=1&bav=on.2,or.r_gc.r_pw.&fp=85be7de52198e892&biw=607&bih=469 2. http://www.thanet.gov.uk/pdf.aspx?page=10443&template=pdf

3. http://online.carmarthenshire.gov.uk/agendas/eng/hscs20060303/rep05-01.htm 4. http://en.wikipedia.org/wiki/Working_in_Partnership_Programme_(WiPP) 5. ^ Scottish Government http://www.scotland.gov.uk 6. ^http://www.dhsspsni.gov.uk/index/hss.htm 7. ^ Prospects website 8. ^http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D 9. ^http://www.dh.gov.uk/en/Publicationsandstatistics/Legislation/Actsandbills/HealthandSocialCareB 10. ^http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGui dance/D

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