NHS partnership working and improvement; we've been here before

A number of large scale programmes are running in the NHS in England where communities are getting together to improve health and social care services. The projects have a wide membership from mostly statutory public sector organisations but also some in the voluntary sector. As some of the strategies sounded familiar I checked the Department of Health website.

I was involved in partnership working in the NHS in the mid and late 1990's. At that time in England there were also Healthy Action Zones which seem very similar to many of the programs underway at present. It seems to topic is coming round again but with a new language and consequently a delay in making changes. There are many papers and documents available form around 2002 - 2004 which have self-assessments, methods, best practice examples, case studies and similar. I find it so disappointing that those who are responsible for the spread of good practice and large scale change feel the need to continue to reinvent wheels - thus not practising what they preach.

If you are interesting in learning what has gone on before and in adopting and adapting existing ideas for large scale change then try out these papers from the Department of Health:

Working in Partnership; developing a whole systems approach (notable because it covers productivity - and this was 2002...)

Governance in partnership checklist of good practice

If you only want what is new then try
Working with Stakeholders which is 2010

Spread or Adoption? Which terminology works best for you?

Do you talk about spreading good practice or helping other to adopt good practice?

The difference is one between push and pull. Spread implies a push out, top down and hierarchical approach and adoption suggests we are unable to do the change and that the best we can do is help someone else to do it.

It sounds subtle but the difference is significant. Enabling the pull is difficult to do using a top down approach in the organisation. Yes, it is not only possible but downright useful for the organisational leaders to create a context and structural environment that enables professionals to be aware of and be able to implement existing good ideas. However, the application, the changes, are made by those who are affected by them, not the leaders.

It sounds to me that in the last year or so healthcare around the world has started to use the phrase large scale change to take the place of spread and adoption. I wonder whether this is due to the difficulty of the original two words?