A story about collaboration in the Health Service

It was one of those moments when I thought I’d got it completely wrong.

We had been working on a major project about integrating health and social care – one of the great challenges facing the UK. We had been supporting a collaboration across health and local authorities for more than a year.

They were looking at how citizens could be better served by joining up services. And they were working together as a model collaboration.

At one of our last meetings I threw a simple question into the mix – ‘So what’s the scope for redirecting some of the health money to social care?’

It wasn’t just that the response was negative. It was as though the question should never have been asked.

Collaboration, yes: handing over cash, never.

Researchers call it the ‘collaborative paradox’. According to Professor Siv Vangen, the paradox comes because ‘gaining advantage requires the simultaneous protection and integration of partners’ uniquely different resources, experiences, and expertise'(Vangen, Siv (2016). Developing Practice-Oriented Theory on Collaboration: A Paradox Lens. Public Administration Review).

In this case, the collaboration partners were prepared to integrate (share) experiences and expertise, but not – it turned out – resources.

They were not clear that to gain advantage you may have to give something up.

And as a consultant and facilitator I’d not helped them work this through.

Professor Vangen’s research suggests that the first thing to do in this situation is to ‘name the paradox’ – get it out into the open.

Now we are working on a step by step process for facilitators and consultants to support collaboration while recognising that it’s inherently paradoxical.

It would be great to hear from other consultants and facilitators who have come up against this issue and what they have done about it.