University of Birmingham

The publication of our final report Towards achieving interorganisational collaboration between health-care providers: a realist evidence synthesis provides a range of options and ideas for all those interested in finding practical solutions for better collaboration.

We have discussed previously that a central finding from our review is that interorganisational collaborations can work well when a series of elements are in place, which includes the need to build trust between everyone involved. Having a belief in the collaboration is also needed to help inspire others to get involved. To try and reduce possible problems, setting priorities and having clear methods to show how improvements can be achieved are important, as well as having an agreed contract in place to ensure that any conflicts are resolved.

Our research finds that if done well, collaboration can improve resource allocation, coordination, communication, and shared learning about best practice. But it is by no means easy.

In the discussion chapter of the report Table 10 provides a series of ‘action statements’ to help think through how best to maximise what we define as collaborative ‘functioning’ and ‘performance’. Here are some of the key lessons for collaborative success:

• The importance of leadership behaviours and attributes that include showing empathy, visibility, generosity, a curiosity to learn from others, and the sharing of improvement programmes and methods
• Enhancing trust and interpersonal ties by giving reflective space to understand any negative prior experiences, as well as building a vision that seeks out ‘quick wins’ to gain momentum, and spaces for interpersonal communication
• Building faith by involving service users and front-line staff in collaborative design to ground a vision focused on outcomes, as well as manage the collaborative ambition to prevent feelings of failure and complexity
• Building confidence by ensuring an appropriate level of formalisation of contract is in place, particularly for more complex or mandated collaborations
• Ensuring capacity is explicitly acknowledged as collaboration requires time, effort, and financial input, and understanding that initial performance drops may occur while resources are redirected

These are just some of the key messages we gathered from our evidence review and interviews with a range of policy, practice, and user perspectives.

The next step for our research is to further extend and support all of those engaging with collaborative efforts with developmental methods to gauge the readiness and progress of a collaboration. Our findings for example show how the ‘maturity’ of a collaboration can be assessed and developed. These and many other recommendations and learning can be taken forward in addressing one of the key challenges of our times.