Public Sector Integration: Tipping Point Or Breaking Point?

Published: 1st November 2016 Category: Highway Code Download Article as PDF

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We are at a high water mark for public service integration.

Never before have there been so many initiatives designed to transform public services through collaboration. Nor has the pace for change been so dynamic.

Are we at the tipping point?

Some argue that we are at the tipping point, where collaborative working will go mainstream.

They cite Sustainable Transformation Plans (STPs) in health, or combined authority arrangements in local government. Place-based devolution deals between national and local governments and area reviews in education. These are their examples of public service transformation through collaboration.

Or breaking point?

Others argue that we are at a breaking point, where public sector organisations are over-stretched, due to rising demands, reductions in funding and the ‘leaning’ of organisations to the point where they lack the head space, resources and capacity to collaborate with others.

Examples cited include adult and children’s services, the integration of health and social care and the pressures of NHS providers.

So, which is right? Are we at a tipping point or breaking point? The answer to this is that both can, and do, happen simultaneously.

Why the paradox?

There are a number of dimensions to this paradox.

The ‘place paradox’: The drive to collaborate, is frequently place-based. People have a genuine shared commitment for their places and their communities. But ‘places’ are also contested. Politicians who contest places via elections and public sector organisations frequently find themselves competing for scarce resources, customers (eg education) and new ways to derive income.

The ‘survival paradox’: Organisations under pressure will naturally focus on self-preservation when the survival instinct kicks in, and can undermine attempts to collaborate with others.

Evidence of survival instinct can be seen where districts and county councils seek different models of local government re-organisation, or where NHS secondary and primary care providers have different visions for new models of care.

The ‘trust paradox’: Successful collaborations do exhibit high levels of trust. Yet sometimes public sector partnerships exhibit much lower levels of trust. A council CEO once said to me that ‘partnership can be defined as mutual loathing temporary suspended in the pursuit of money’. As a guide, partnerships that exhibit low trust behaviours, tend to focus on the deal, rather than building trusted and sustainable relationships.

Here is the rub, no matter how compelling the ‘deal’ is, poor partnership relationships are likely to scupper it. This is why forcing organisations to share is frequently unsuccessful.

With so many dimensions to the paradox, can they be overcome?

We believe that there is also the tipping point and breaking point paradox.

This paradox happens when the case for collaborative working and the need to change one’s organization both become self-evident at the same time.

It happens when leaders recognize that, only by working with others will they  achieve their objectives and this will require the organization to re-imagine itself to make it relevant in this new context.

When these stars align, the opportunity to genuinely transform public services through collaboration becomes real.

Making the most of the tipping point and breaking point paradox

So, how can leaders help make the stars align and leverage the potential of the tipping point and breaking point paradox?

Based on my experience of working with local authorities, CCGs, STPs, blue light and education, we would suggest that leaders come together and focus on three things:

Having the right conversations: Ensure that they talk about the important issues not the side shows

Build the right relationships: Invest in the relationships and agree on how they work together to make change happen

Bring their organisation to bear on the project: Commit their organisation’s resources to the shared endeavour and through the right leadership behaviours evidence that the change is going to happen no matter how painful to the traditional ways of working for staff or management

If the leadership embraces the tipping and breaking point paradox and focuses on these three actions, it will accelerate the pace and scale of collaboration projects.

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