Here, James discusses the latest (but not the final) report generated by this work together, and which explores emerging multi-layered preventative partnership working, as per the Christie Commission agenda.
Building an action research focus around the Christie Commission narrative
In our action research work with Aberdeenshire Community Planning Partnership we have sought to use the Christie Commission’s narrative on public service reform as a key backdrop to support ongoing local discussions and dialogue on policy, practice and related evidence.
At an early event – the first Collaborative Learning Day on 'partnership and participation' – we began by asking the participants to reflect on: "what does putting 'Christie' into action’ mean to you?" One person commented that this was an ambitious question to expect participants to answer … and yet the question generated rich discussions on the day, and has continued to do so as our work has developed.
This latest Aberdeenshire co-produced report on Multi-layered Preventative Partnership Working records and reflects on this tranche of action research activity with the CPP. It illustrates the complexity of ‘partnership and participation’ being pursued across different layers of community planning – community-based, area-based, centrally-based – and the multitude of different partners and sectors involved.
Further, the report explores partnership-working focused on a key concern for the Christie Commission – preventing inequalities (and other 'negative outcomes') within an aspiration for a fairer, more equitable society. NHS Health Scotland's 2014 report Best preventative investments for Scotland: what the evidence and the experts say, produced by Neil Craig, has provided a valuable evidence-informed framework for supporting discussions. It argues for, broadly-speaking, upstream, whole-population, system-wide approaches as most likely to reduce health inequalities, improve health for all and reduce pressure on services. Examples include: adequate incomes; better environment and access to services; early years interventions; use of legislation and regulation.
The report tracks some of the developing (facilitated) dialogue and learning within the CPP to build preventative approaches through strategic and operational partnership working in relation to:
- the work of Aberdeenshire Health and Social Care Partnership and its CPP partners to explore and build a strategic approach to community capacity-building for health and well-being
- the work of Aberdeenshire Alcohol and Drug Partnership and its CPP partners to develop a Local Outcomes Improvement Plan (LOIP) priority and action plan focused on changing Aberdeenshire’s relationship with alcohol.
Promising areas of practice for further exploration
These two developing strategies are very much works-in-progress – promising areas of practice – yet they illustrate emerging issues, opportunities and challenges at the 'frontiers' of preventative partnership working.
|Three emerging areas of challenge:|
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- The potential value of investing time in discussing and deepening understanding of the evidence base related to prevention (NHS Health Scotland: Craig, 2014) with the full range of stakeholders.
- The potential role of deliberative approaches that go beyond dialogue across partners, engaging them in challenging discussions and the shared development of reasoned next steps.
- The opportunities to explore external sources of investment for prevention via public sector and community sector enterprise which could build local economic and social development strategies.
- The potential of local community sector organisations to work with communities and public service partnerships to build relevant local dialogue and deliberation.
There are further reflections within the report, too, from within Aberdeenshire CPP about 'next steps' for other areas of partnership working e.g. child poverty and community empowerment.
Crucially though this seems to be - unsurprisingly - challenging work requiring patience and commitment. In particular, because there is a limited evidence base (both for and against) for partnership working as a vehicle for improving outcomes - given the complexity of partnerships and related outcomes. For more on this see the What Works Scotland evidence review on Partnership Working across the UK Public Services. And similarly, there are limits on the evidence base in relation to community-led, assest-based approaches' to improving health inequalities. (Craig 2014)
There seems to be no simple, evidenced roadmap to success – 'here’s what to do'. Instead we might imagine ourselves as mapping out the 'frontiers' of this collaborative approach. Here, the notion of working with 'wicked issues' as a dynamic, on-going 'wrestling' with inter-related social problems by diverse, committed stakeholders working within complex systems feels a more realistic outline for a process - a constant searching for 'next steps'.Broadly speaking then, 'collaborative governance', as discussed by Chris Ansell and Alison Gash in their article Collaborative Governance in Theory and Practice.
A rare opportunity for a longer-term, committed approach to preventing inequality?
So, what does happen if, as the Christie Commission advocates, 'we' seek to engage, through partnership and participation, over the longer-term with a complex, intractable set of social problems such as preventing inequalities?
This report on preventative partnership working offers some emerging material to support reflection, and in response to new opportunities arising from the Community Empowerment (Scotland) Act 2015 and the Public Bodies (Joint Working) (Scotland) Act 2014. We are also working towards a final learning report that draws on reflective interviewing with the CPP partners to map further these frontiers of collaborative policy and practice.
The Christie Commission narrative, however, given its longevity, also offers an unusual opportunity. For it has generated a broad, legitimised policy and practice space that supports both practical discussion and critical reflection on public service reform - a space that is of relevance to many sectors: public sector, third and community sector, government, academic/research, trade unions, private sector. We have then the chance to continue to focus through public service reform on the stubborn inequalities that have dogged us since the 1980s and see if we can work out what multi-layered preventative partnerships might realistically achieve here, and for whom.
See the Aberdeenshire case-site webpage for an overview of all the CPP and What Works Scotland research