Co-operative working in interagency settings

Over the past 100 years ideas derived from management, and more recently leadership, have become ever-present concepts in our everyday lives. When an organisation – or groups in society more broadly – encounters difficulty, almost invariably it looks towards some form of individual leadership to guide it through the time of turbulence or to take the blame for failing to do so.

However, the “organisation in our heads” still tends to be heavily influenced by the principles of classical management theory which assumes hierarchical relationships between members of a single organisation. This perspective on organisational life has two major implications for the consideration of management and leadership in inter-agency settings.

Senior managers

Firstly, in the creation and maintenance of collaboration between independent agencies, it has privileged the importance of senior managers within the organisations forming partnerships, rather than those individuals developing the relationships between partners. In other words, we still look towards leaders and managers who have hierarchical powers in agencies, rather than those who span agencies.

Second, it creates an environment where there is a strong predisposition (in particular in public services) to turn effective inter-organisational partnerships into a new form of hierarchy. In other words, hierarchies are so embedded within our concepts of organisations, then we invariably attempt to turn any new form of structures into hierarchies in order to make them more familiar.

But this poses particular problems where arrangements involve the voluntary co-operation of a number of agencies and/or individuals (whether in a clinical network, a joint or integrated team, a shared governance arrangement etc) as health and social care partnerships invariably do.

As discussed in the previous article in this series (Community Care, 15 May) evidence for the positive impact of partnerships is scarce and accounts of challenges plentiful. Rather than deploying systematic interventions to overcome these difficulties (which may take considerable senior management time and attention), agencies involved in partnerships have typically used the appointment of individual managers – network co-ordinators, integrated service managers, joint commissioning managers – to glue these entities together.

It is presumed that these post-holders will solve the problems created by these obstacles when they can – and negotiate a way around them when they cannot. Leadership, therefore, is often cited as a crucial factor in building effective partnerships and is often identified retrospectively as being a key ­factor in the success (or otherwise) of ­inter-agency initiatives.

This optimistic belief in leadership is not just a quirk of the partnership field, though an enthusiasm for leadership has swept over most public services over the past 10 years. Although leadership and management are possibly some of the most written about phenomena of the past 50 years, the evidence base is far from conclusive. Further, the evidence base relating to leading and managing in inter-agency settings is even more limited in terms of scope, focus, consistency and credibility. Yet, despite this, much of the literature relating to theories of inter-agency collaboration still make bold claims about the role of leaders in managing sets of complex organisational, structural and cultural factors.

However, in our enthusiasm for leadership we may well be overlooking other important causal factors when considering the success (or, indeed, failure) of partnerships. Therefore, we should be a little cautious here about the enthusiasm of some research for the leader as key variable in leadership success rather, the question should be not “did leadership lead to the success of this partnership?” but “how big a part does leadership really play in the trajectory of effective partnerships?”.

Some commentators have noted that the challenge of leading and managing inter-agency partnerships is a more difficult task than operating in traditional hierarchical organisations. The former may lack a common framework between partners one partner may hold more power than other(s). The partners may have incompatible values, have unclear authority and communication channels and different ways of communicating between professions.

Interagency settings

Of course, these latter three characteristics, at least, may also be present in established and apparently hierarchical public service organisations. Nonetheless, this does start to map out the contours of the particular terrain that has to be negotiated by those managing and leading in inter-agency settings.

In fact, looking at the leadership of networks there is little particularly distinctive either about the activities or about the skill sets of people spanning boundaries between organisations when compared, for example, with colleagues working between departments within an organisation. Indeed, much of the literature moves seamlessly from the inter- to the intra-organisational context. This is a slightly controversial position to adopt, but one that may usefully serve to demystify the concept of leadership in inter-agency settings. There may be nothing unique to partnerships about the leadership styles and skills that facilitate their success rather the difference may lie in the emphasis on particular elements of a more generic leadership model and in the specific contexts.

What appears to be clear from the literature about managing and leading in inter-agency settings are the following:

● Although effective leadership and management do have a significant impact on the functioning of inter-agency collaborations, it is important that leaders’ roles are not overstated, and that we are realistic about what types of leadership and management can produce what kinds of results in what sets of circumstances.

● Although it is often suggested that leaders and managers of inter-agency collaboration need distinct skills and attributes to those operating in more traditional settings, this distinction can be overstated there are also significant overlaps in the types of tasks and challenges that both sets of leaders and managers will face and these should not be underestimated.

● There is a need to be clear about what types of motivations lay behind any ­collaboration. These are important to establish as they influence the form that any ­collaboration takes and the difficulties which it may encounter.

● Different sorts of collaboration require different types of leadership and management, and it is important to consider the aims of the collaboration and the types of tasks that they have been set up to address. Both these factors will influence the nature of leadership and management which will be most effective within these settings.

● Regardless of the form of the network, different leadership and management attributes will prove more effective at certain points during the collaboration than others.

In this text we develop characteristics of managing and leading in inter-agency settings and suggest frameworks which may aid leaders and managers of inter-agency settings to engage more effectively with other key stakeholders. Although leading and managing in inter-agency settings is a complex task, by taking account of the motivations for that collaboration and the linkages between agencies there is a range of activities and attributes which leaders and managers may privilege over others and which may make them more effective within that particular setting.

● Helen Dickinson and Jon Glasby, Health Services Management Centre, University of Birmingham, are the editors of the new Better Partnership Working series. Click here for further information

● This article is based on material from Edward Peck and Helen Dickinson’s Managing and Leading in Inter-agency Settings, the second book in a new series focused on Better Partnership Working. Published by Policy Press in association with Community Care, the five books seek to provide a series of accessible “how to” guides. These books summarise current policy and research in a detailed but accessible manner, offering practical support to those working with other agencies and professions and provide some helpful frameworks with which to make sense of the complexity which partnership working entails.

Over the coming weeks, Community Care will feature a series of articles on each of the topics in the book series: teamworking interprofessional education and training managing and leading in interagency settings and evaluating outcomes in care.

Click here for more examples of partnership working visit our good practice database

Published in the 19 June edition of Community Care under the heading A Question of Leadership

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