Tag Archives: communication

To Teach Empathy, Try Theater

Photo: Dea Andreea/Unsplash. When a child is in a play, she can see what it’s like to be someone else for a while. You don’t really need a reason to justify doing theater with children. It is just so much fun. But if you need a reason, think about what theater-engendered empathy and active listening […]

To Teach Empathy, Try Theater

Labour shortages in food supply chain – independent review launched… £6 million funding to improve housing and support for vulnerable tenants…Preserving Taiwan peace

and also: £6 million funding to improve housing and support for vulnerable tenants Preserving peace and stability across the Taiwan Strait: G7 Foreign Ministers’ statement   Editor’s note: The following are Government communiques / press releases which you may / may not have read about. Not all involve politicians. But not all the headings on […]

Labour shortages in food supply chain – independent review launched… £6 million funding to improve housing and support for vulnerable tenants…Preserving Taiwan peace

Developing effective commissioner–provider relationships

Vic Citarella – a post that first appeared on RiPfA website on the 9th March 2017
As everyone seeks to squeeze more out of the social care system, how can strong and positive relationships lead to improved and more cost-effective working practices?
I have recently authored a Strategic Briefing for RiPfA on effective commissioner-provider relationships and facilitated a workshop on the same topic. I will also be leading their upcoming open access webinar ‘developing effective commissioner-provider relationships’ (28 March, 12-1pm, online). As part of my approach to gather evidence relating to this work, I began by asking some initial questions. I found it helpful to test out some of the underlying assumptions, namely that:

  • there is a problem
  • the relationship that matters is the one between the commissioner and the provider
  • such relationships have character – effective, strong and positive – which can be improved
  • there is an answer to the problem.
Problem – what problem?
Clearly social care is experiencing unprecedented financial pressures which is characterised as a problem or even a ‘crisis’. RiPfA identified this as a key issue back in 2012 in the publication: How to maintain safe, effective and quality services with reducing resources.

The underlying assumption is that integral to the problem are poor relationships between commissioners and providers. Community Care and the Guardian certainly think so. The guidance and toolkits say so. If only commissioners and providers got on better, they could make the money go further and people in need would get what they want. Implicit in this assumption, and reinforced in the Care Act 2014 guidance (Chapter 4), is that it is for the commissioner to do something about this problem. They have the money, the power and are the public authority.

But is this in fact the case? Does the responsibility lie at their door? The forthcoming webinar offers an opportunity to check this out.
A many-faceted relationship
Perhaps a more worrying assumption is that the relationship we are talking about involves just the two parties – commissioner and provider. But social care is patently a more complex system involving lots of people, organisations and stakeholders. Relationships between two people are hard enough. Imagine how much more convoluted relationships are in the multi-agency, multi-professional and multi-faceted world of social care.

The webinar session will try to unpick some of these relationship interactions and dynamics, and look at common purpose, co-production and role clarity. We will look at ideas around stakeholder mapping, user-led approaches and person-centred coordinated care.
The character of a relationship
That a strong relationship is a positive one and leads to more effective services is another assumption we can test. From there we can explore what steps can be made to build strength in relationships. How we turn our social care values into commissioning and service providing practice is the proving ground for the customers.

Clearly trust and communication are at the heart of all kinds of relationship building – but what do you actually do to make these things happen? The webinar will also look at how the behaviours of the participants in the commissioner-provider relationship can be (positively) developed, drawing on examples that have been tried involving individuals, groups and organisations in a variety of settings and formats.
A problem demands a solution
Lastly there is an assumption that there is an answer to the problems of poor commissioner-provider relationships. There is no sure-fire formula for success. Like personal relationships, those in business and between organisations require continuous work (and as with personal relationships there are online quizzes to evaluate the partners’ starting point and where they want to go with a business relationship, for example: http://www.growthink.com/content/finding-business-partner-take-quiz). In fact, the similarities between the advice offered by relationship counsellors and business gurus is quite remarkable. Writ large are trust, open communication and respect.

What we will examine during the webinar is ways for commissioners and providers to work together, how to make the time, and some methods that have been found to work. We will consider approaches to procurement and contracting as procedural processes to cement relationships, to record agreements where the players may change and to cater for endings and failures as well as success.
If you are a commissioner or service provider (of any kind – registered/not registered/large/small/private/voluntary), please do join us at the webinar on 28 March. As we are looking at relationships between commissioners and providers in social care then it would be beneficial if people who have worked together in these roles could participate jointly (although this may of course not be possible). People who use services and/or directly commission for their own needs are very welcome to attend.

If you have any thoughts or questions, please email me in advance at vic.citarella@cpea.co.uk– although I am not offering relationship counselling!

About the author
Vic Citarella is a qualified social worker and a former Director of Social Services. He now works with local authorities, NHS bodies, private and voluntary social care providers, to help them improve standards and quality of services.

Related resources

Integration – Merger or Acquisition?

Vic Citarella, Director of CPEA Ltd, draws on business leadership lessons to make some timely observations about integration in social care and health

Policy makers are convinced that integration of social care and health is a good thing, despite the weak evidence base. For example, a lot of hope is vested in the eventual success of the current drive to integrate through the effort of pioneers.

While there is something of an act of faith in all this, we all instinctively know there is something right for the customer in being more joined-up. In fact, some of us have been working at it for over 30 years! So maybe now is the time – austerity being the parent of innovation – we may actually see the system change.

But in what direction?

We all have different ideas of what integration looks like. And of course, it being a way of working, it is not an ‘end’ in its own right, but only ever a means to an end.

So, let’s turn our attention to describing what good integration looks like. Why? Because it appears that this is how we will be measured and what will ensure that a trickle of their own money keeps dripping in the direction of our customers.

In thinking about this, I have been taken with what the business sector has to say about merger and acquisition (or M&A as it is usually known). This is neither to suggest that this is something to aspire to or avoid – but rather to learn from. It is of note that in pure business M&A can be an end in itself, if it meets the primary purpose of making money, whereas in a public service it is always a means, as the purpose is service (usually).

With that explained, three recent observations:

First I heard Professor Jon Glasby speak at an ACCORD Group event in Birmingham recently. He had this warning about M&As in our sector, saying that they:
• Only partially achieve stated objectives
• Do not save money
• Reduce morale and productivity
• Struggle to reconcile ‘cultures’ and that this is a major cause of failure
• Stall development for at least 18 months
• Never achieve true ‘regime change’

Sobering agreed, but the professor went on to give an upbeat message about focusing on outcomes, with his suggestion that the best way to do this was by asking just three questions – where are we now, what do we want to achieve, and what do we need to?

Second, an advert on the rear cover of the CASS Business School magazine In Business caught my eye. It said: People are the key to successful M&A, in bold to catch the eye. I read on and will quote what the advertiser had to say in full as it warrants our attention:

People are the key to any merger or acquisition. Without their commitment, energy and ideas, a deal won\’t succeed. We help our clients build and execute an integration approach that recognises the cultures of both organisations while creating the change necessary for the new organisation to flourish. Using proven change management and communication strategies, we work with our clients to manage the process from the pre-deal stage through integration.

What to make of that? Well what went through my mind, as a \’workforce\’ person, was to say spot on. I took the magazine, making an entry into Evernote to translate this into the language of social care (and health). Business Opportunity!

Third was this from The Texas CEO Magazine. Here Randy E. Pruett blogs about ‘Mastering Employee Communications and Commitment During M&A.’ This is worth a read on a number of levels – it states the obvious, it’s readable and nothing to do with social care and health, it’s timeless and relevant and it shamelessly re-uses some leadership classics:

1. Martin Luther King didn\’t say ‘I have a strategic plan’!
2. In truth, the only person who likes change is a wet baby
3. Three people who were at work on a construction site. All were doing the exact same job, but when each was asked about his or her job, the answers varied, rather tellingly. The first replied, “Breaking rocks.” The second said, “Earning a living.” The third answered, “Helping to build a cathedral.”

You just have to admire Randy packing all those and lots more goodies into one blog. Read it if you are thinking about integration.

The lesson from these three observations is that we must ask ourselves whether we are talking in a particular context about M&A or something else. If not then we must articulate quickly and together what we do mean by integration, as the default position is likely to be organisational change and we all know what that entails.

Meanwhile, there are pitfalls and prizes, that while they may not be researched well in social care and health in the UK – are familiar in other sectors and countries, and we can profit by paying attention to them.