Working in Partnership

AuthorPaddy Cooney
Publication Date01 Sep 2002
Working in Partnership
Paddy Cooney
Chief Executive
Somerset Partnership
Personal Perspective
ntegrated care is a concept bringing together
inputs, delivery, management and organisation of services
related to diagnosis, treatment, care, rehabilitation and
health promotion. Integration is a means to improve the
services in relation to access, quality, user satisfaction and
efficiency.’ World Health Organisation – Working
Definition, 2001.
The benefits of working in partnership are so self-
evident that no professional individual and no
organisation providing interventions would want to
move forward without being in partnership with those
around them. As the WHO definition states, it is a
means and not an end and the end is delivering
interventions which meet the needs of users of mental
health services. All the organisations involved will
have the equivalent of a mission statement, indicating
that their aim is to meet the needs of users. With such
a convergence of aims, there can be no problem in
deploying our resources in partnership with other
agencies to meet those needs. And the alarm clock
goes off demanding a return to the real world.
Why is it that partnerships in general, and the
relationship between health and social services in
particular, are so difficult to develop, nurture and
maintain, when most of the caring organisations are
staffed by generally reasonable, sociable and likeable
individuals? People often pushing to be at the cutting
edge of service development have to attend a distant
relative’s funeral when partnership is due to be
discussed. It is all the more surprising when the
grassroots of the respective organisations have
effective, albeit at times imperfect, working
relationships which operate across the boundaries so
carefully constructed by the edifice above them.
It seems to me that the first part of the answer lies
within the baggage we bring into the room in which
we are discussing partnerships. The predecessor
activity to partnership working was joint planning,
which all too often took place after the decisions had
been made. Uni-disciplinary or uni-organisational
meetings were held prior to the joint planning
meeting to discuss the agenda and agree positions,
much in the manner of the meetings which preceded
union and management meetings. Most of us have
moved away from that frustrating scenario, although
even in those circumstances a number of individuals
managed, despite the structure, to develop creative
and imaginative services whose legacies still persist
today. But moving to different forums and structures
does not always mean we change how we perceive our
partner organisations. This is frequently polarised,
stereotyped and ingrained in the respective
organisations to such an extent that it could be viewed
as institutionalised. Movement is often dependent on
the disproportionate influence of individuals who in
the face of the critical mass of the organisation either
pursue joint working or invest in maintaining the
status quo. Either way, it is not owned at all levels of
the organisation, which is a pre-requirement for
effective partnerships.
Second is the underlying issue of power, whether
professional or organisational. Partnerships should
benefit all involved equally whether providers or users
of services, but this entails a sharing of the power.
What should be seen as the advantage of gaining the
greatest benefit for the greatest number is
reinterpreted as the loss of control and power, and
hence status, to the individual organisation or
profession. This is seen as much in senior managers
who measure the worth of the organisation by its size
and diversity of provision, as it is in professionals in
multi-disciplinary teams who baulk at the very
thought of being supervised by another professional.
Power can be enhanced by devolving it, instead of
treating it like a finite commodity which is diluted by
sharing and in which there is little left over for
frontline staff, while users and carers are left with
empty begging bowls.
Third, the modernisation agenda has imposed the
The Mental Health Review Volume 7 Issue 3 September 2002 ©Pavilion Publishing (Brighton) 2002 3

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