The quango NHS England has just published guidance on “Expected ways of working between integrated care partnerships and adult social care providers“. This is the latest direction on how to implement the contentious 2022 Health and Care Act, that received Royal Assent in April 2022. The Health and Care Act 2022 is remarkably permissive; this […]Government by diktat: adult social care companies must have decision making powers about NHS and social care commissioning
Tag Archives: integration
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.