care coordination v partners in recovery€¦ · nous group.com.au 5 • many people with severe...
TRANSCRIPT
nousgroup.com.au 1
Care Coordination v Partners in Recovery
VICSERV Seminar
November 2012
nousgroup.com.au 2
Contents
1. Care Coordination v Partners in Recovery
2. Care Coordination insights
3. How partnerships work
nousgroup.com.au 3
Contents
1. Care Coordination v Partners in Recovery
2. Care Coordination insights
3. How partnerships work
nousgroup.com.au 4
Care Coordination for people with severe
mental illness and multiple needs (delivered
through selected PDRSS)
• Care Coordination was part of a 2009-10
State Budget reform package
• Care Coordination aimed to address priority
pressures, risks and opportunities
associated with high risk/high need adult
clients (16-64 years) of the specialist public
mental health service system
• Care Coordination provides the practical
support to access and remain engaged with
the range of mental health and general
health and social support services they need
CC and PIR came about because of a lack of coordinated and integrated care available for people with severe and persistent mental illness.
Source: Department of Health and Department of Health and Ageing
PIR aims to improve the system response to,
and outcomes for, people with severe and
persistent mental illness who have complex
needs (delivered through Medicare Local
regions)
• PIRs is part of the 2011/12 Federal Budget
which has provided $549.8 million from
2011/12 to 2015/16
• PIR will get the services and supports from
multiple sectors to work in a more
collaborative, coordinated, and integrated
way
The scale of PIRs
dwarfs CC but they are
the very similar
programs
nousgroup.com.au 5
• Many people with severe mental health illness and psychiatric disability have multiple and complex
needs such as co-existing substance misuse problems, co-occurring physical health problems and/or
intellectual disability and Acquired Brain Injury.
• This client group require a response from a range of service sectors such as health, housing,
homelessness, drug and alcohol treatment, family support and justice.
• It is estimated that one third of all clients of the clinical specialist mental health service system
(approximately 20,000 clients) require dedicated assistance to access the these services, and would
significantly benefit from the development of an integrated, comprehensive care plan that is able to be
modified over time to reflect their changing needs.
• These clients have a high level of dysfunction across several life areas and a limited capacity for self
management, making it very difficulty for them to navigate the complexities of multiple service systems,
particularly when they are unwell.
• The need for sustained support recognises the episodic and enduring nature of serious mental illness.
• In the absence of coordinated tailored packages of support, these individuals are at high risk of falling
‘between the cracks’ of highly siloed service systems.
• This can lead to negative client outcomes such as repeated crises and hospitalisation, entrenched
isolation and poverty, recurring homelessness, long term unemployment, poor physical health and
frequent interactions with the police with a higher risk of incarceration.
CC and PIR tackle the same problem. Below is the background to CC but the same could be read to PIRs….just on a national scale.
Source: Department of Health
nousgroup.com.au 6
There is overlap between Care Coordinators, Support Facilitators and….Clinical Case Managers.
Differential role of care coordinators, case managers and support facilitators
Care Coordinators Clinical Case Managers Support Facilitators
� Service system coordination - Operates more like
‘service coordination’ or ‘service hub’ - works with, and
guides, the service team process and tasks while building
collaboration with all parties involved with the client
� Long-term focus - Takes a long-term planning focus.
Supports the care team, coordinates the broader
community-level service plan, provides guidance around
service delivery and may help to coordinate crisis
intervention activity
� No direct engagement – Care Coordination does not
include the provision of psychosocial supports and the
Care Coordinator does not engage in direct day to day
work with the client. Client engagement is through
assessment or review of the care plan and focus on how
the client perceives the services to be working. Typically
only meets the client with one of their direct support
workers, Case Manager or in a case conferencing
environment
� Clinical service guidance - Works with
and guides the service needs of the
client specific to that agency, and does
provide direct clinical support to the
client
� Direct engagement - Does have a
component of service coordination and
hence there is some overlap with Care
Coordination
� Long-term focus - Similar to Care
Coordination, takes a long-term
planning focus, but also works with the
client, providing direct support and
involvement, develops an agency
specific or treatment plan and is
directly involved in crisis interventions
� Deliver the benefits of system
collaboration
� Support facilitation with a
coordination focus;
� Manage referrals, assess client
needs
� Develop, monitor and regularly
review PIR Action Plans
� Work with existing case managers
(not replacing them)
� Build service pathways, networks
of services and supports needed
� Be a point of contact for PIR
clients, their families and carers.
Overlap with planning.
Leave clinical care
plans to clinicians. Take
a load off clinicians
Source: The Nous Group and Department of Health and Ageing
nousgroup.com.au 7
• Case management delivered by specialist clinical mental health service (as defined in the
Framework for Service Delivery ) was intended to provide holistic care, assisting the clients in
all life domains, such as support to develop daily living skills and access social support
services.
• In practice, clinical mental health services do not have capacity (or in some instances
knowledge of referral pathways) to effectively perform this function for all clients, mainly
due to increased complexity and sustained demand pressures.
• As a result, case management is variable and ad hoc.
• It is also acknowledged that clinicians’ skills would be more efficiently and effectively used to
deliver clinical treatment and interventions.
• The introduction of a dedicated non clinical care coordinators function would (subject to
adequate investment over time) allow the redevelopment of treatment and support is
coordinated for clients with severe and enduring mental illness.
Care Coordination aimed to free up clinical services to focus on providing clinical treatment and treatment planning, review and medical monitoring of high need clients.
Source: Department of Health
nousgroup.com.au 8
Contents
1. Care Coordination v Partners in Recovery
2. Care Coordination insights
3. How partnerships work
nousgroup.com.au 9
Care Coordination seeks to support targeted clients with multiple needs to access and remain engaged with the range of health, community and social support services.
CLIENT OUTCOMES
Health
• Improved self-management of illness, medication and treatment compliance, relapse prevention and symptom stability
• Improved physical health and engagement with GP services
• Decreased psychiatric crisis, suicide, self-harm and other
• Sustained engagement with health, drug and alcohol, primary mental health and medical services as appropriate
• Improved client and carer experience of care, improved client and carer input into treatment care planning
Social:
• Sustained stable housing
• Increased social and community engagement/connectedness
• Improved social relationships, including with significant others
Economic:
• Engagement in educational and vocational training, and employment
Brokerage funding
($500 per client)
OUTPUTS OUTCOMESACTIVITIES NEED/PURPOSEINPUTS
• $2M per annum
• 20 new positions
• Indicative worker to
client ratio - 1:15
• Selected PDRS service
providers
efficiency effectiveness appropriateness
AMHS registered clients aged 16-64 who have a severe, enduring mental illness and psychiatric disability and:
• multiple, unmet service needs
• a history of accessing a range of services in an ad hoc and often chaotic way.
Note: Clients who are currently receiving SECU diversion and substitution or IHBOS are not eligible for this response
• Improve treatment and care of multiple need/high need clients
• Reduce system
pressures
SYSTEM OUTCOMES
• Improved service coordination and strengthened accountability at the local level
• Increased capacity for specialist (clinical and PDRSS) mental health services to manage service demand
• Reduced repeated contacts with other service systems i.e. hospital, corrections, homelessness, and emergency contacts (police and ambulance)
Brokerage services
Links to wide range of clinical,
psychosocial, rehab, physical health and
social services.
Case Conferencing
Assessment, development, coordination
and review of personalised Integrated
Care Plan
System advocacy
System outcomes
Health, social and economic
client outcomes
Standardised intake and assessment framework
20 Care Coordinators
delivering up to 300 Integrated Care plans at any one time
Source: Nous Group and Department of Health
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The Nous evaluation has two components:
1. The formative evaluation component – this
examines issues related to implementation. The
key question is: “Is the initiative being
implemented as planned?”. This covers:
• overall governance
• client intake, referral and discharge
• service models
• staffing arrangements
• key Enablers/Challenges
• local delivery arrangements
• involvement in care.
2. The summative evaluation component – this
assesses whether the intended client and
system outcomes have been achieved. The key
question is: “Has the initiative produced the
planned client and system outcomes?”
Nous has evaluated Care Coordination since inception.
Source: Nous Group and Department of Health
Data source Comment
Document
reviewProvider models of care.
Service
provider survey
The content covered in the survey covers:
� intake, referral and discharge criteria and processes
� engagement model
� local delivery arrangements
� enablers and challenges.
Service
provider
interviews
Interviews cover:
� changes in roles, staffing, etc. since the last interview
� client and carer experience and involvement
� system impacts.
Case studies Provider provided case studies
Service
provider
supplementary
data
Service providers submit data for each client about housing
type, employment type, and interactions with other services
Service providers submit BASIS32 scores for clients when these
are not recorded in the CMI-ODS
CMI-ODSUse of beds and ambulatory services by each client
BASIS32, HONOS and LSP scores for each client
nousgroup.com.au 11
All services have established governance structures to monitor the Care Coordination that include pathways for receipt of referrals and consideration of client eligibility.
Source: Nous Group and Department of Health
nousgroup.com.au 12
Client load is between 8 – 10. The plan was for 15.
• Average client number per Care Coordinator increased to 8.75 (from 8)
• Reasons not to take on more clients are:
• clients require more time due to their complexity
• insufficient referrals from providers.
Waitlists are not used
• Only one provider has a waitlist, they operate with a caseload of 10
• Providers state that caseloads could increase if referral process improves
Eligibility is tightly managed
• Providers have kept with the Government criteria
• Some providers noted that eligible clients are not in the program because:
• clinical staff members reluctant as it may create more work for them
• Care Coordinators are challenged by the level of complexity of clients
• the benefit of Care Coordination is still under-appreciated.
Care Coordination case loads vary and referral processes have been problematic.
PIRs has a
similar case
load
requirement
Waitlist
should be big
in PIRs
Managing
eligibility will
be a
challenge in
PIRs
Source: Nous Group and Department of Health
nousgroup.com.au 13
18 months to mature
• Service delivery in terms of client intake, referral and discharge, and the promotion of
the initiative to local AMHS have taken 18 months to mature. Components include:
• Area mental health staff understanding of the role of care coordination staff
• Clinical governance structures to support delivery of this initiative
• Referral protocols within each area mental health service
• Joint planning and decision making
• The area mental health service sharing client information with your agency
• Common tools with our area mental health service
• Joint service delivery protocols.
• Once an effective working relationship between a PDRSS and AMHS provider has been
established then it seems to work well
A range of set-up challenges exist
• Issues that sit behind this include:
• Poor history between providers
• AMHS don’t refer to PDRSS
• Client complexity
• Staff turnover and lack of a system approach
• Overlap between Care Coordinators and Clinical Case Managers
Care Coordination intake, referral and discharge processes have taken more than 18 months to mature.
PIRs will
demand even
more from the
service
delivery model
Manage the
risks and
escalate
quickly, where
necessary
Systems
thinking and
managing
personal
relationships is
key
Source: Nous Group and Department of Health
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Housing providers are the most important provider of non-mental health services.
Source: Nous Group and Department of Health
Importance of other services in the provision of care for clientsRelative ranking
PIRs will be similar in
profile & therefore tells
you about who you need
to connect with and the
skills to do this with
nousgroup.com.au 15
With Care Coordination, clients increasingly use private housing but their employment status doesn’t seem to change.
Data is presented as the percentage of clients occupying each housing or employment type in the time period since entry to the initiative. The number of
clients for which data is available in each time period is presented above each column.
Source: Supplementary evaluation data provided by agencies
Proportion of clients (%) Proportion of clients (%)
Housing type Employment status
3231 19 14 11
42
34 1917
213
8 73
1
9
2 1229
14 8 4 37 6 4 3 2
0%
20%
40%
60%
80%
100%
0 - 3 3 - 6 6 - 9 9 - 12 12 - 15
Supported residential Private housing
Psychiatric inpatient / rehab Homeless
Crisis or transitional housing Private boarding rooms
160 138 88 62 51
0%
20%
40%
60%
80%
100%
0 - 3 3 - 6 6 - 9 9 - 12 12 - 15
Unemployed Paid Part Time Volunteer Paid Casual
months since entry into initiative months since entry into initiative
PIRs will be
similar in
profile
nousgroup.com.au 16
60-80% of time in the initial period is focused on network set up
• The complexity and high level of needs of the target group means that Care
Coordinators have to spend a lot of time in the initial stages to establish a range
of support networks for the client.
• In addition, the Care Coordinator has to establish many more relationships than
other roles, including multiple contacts across all bed-based and community-
based clinical services, and across a wide range of external providers.
• This can be very time consuming particularly while the role itself is being
established.
Once set-up, 10%-30% of time is spent on maintaining networks and referrals
• Most of that time is spent developing and maintaining relationships with
healthcare providers with some time spent with housing providers.
• The allocation of time is closely reflected in the amount of client referrals and
contacts with each of these service providers, particularly for GPs, allied health
and housing
Establishing service support networks has taken more time than anticipated.
PIRs will have
the similar
establishment
challenges
PIRs will
probably have
a similar profile
Source: Nous Group and Department of Health
nousgroup.com.au 17
Most of that time is spent with healthcare, housing and social participation providers.
Data is presented as the number of clients that have the indicated number of contacts/referrals. Only clients for which more than 6 months have elapsed
since entry into the initiative are included in the sample.
Source: Supplementary evaluation data provided by agencies
Number of clients
0
20
40
60
80
100
120
140
160
180
None 1 to 6 7 or more
Health services
D&A services
Homelessness/
housing services
Employment/education/
participation services
Number of contacts/referrals
Source: Nous Group and Department of Health
nousgroup.com.au 18
Care Coordination clients’ carers are increasingly involved in client care.
Source: Nous Group and Department of Health
Carer engagement in IHBOSType of engagement
0 2 4 6 8 10 12 14 16
Service planning and development
Coordination of care
Decisions relating to client's care/support
Governance structures
Recipients of information and referral for carer’s support needs
Other
Number of responses
Round 3
Round 2
PIRs is an
opportunity to
do something
different with
carers
nousgroup.com.au 19
Carers have expressed views on specific challenges
• Actively increase carer involvement
• Strengthen links to family support services
• Conduct carer forums
• Deliver information sessions
Providers have suggested improvements
• Understanding the mental and community health systems
• Finding contact points within the service system
• Carer fatigue due to inadequate support available
• Disjointed and inconsistent service delivery
• Managing the behaviour of the person they care for
Carers have expressed views on specific challenges, and providers have suggested improvements.
Again…PIRs is an
opportunity to do
something
different with
carers
Source: Nous Group and Department of Health
nousgroup.com.au 20
Providers use different recovery models
• Most Care Coordination providers refer to their use of the Collaborative Recovery Model and the Recovery Star Models
as important aspects of client engagement.
Clients are involved in recovery planning 40-60% of the time
• Clients and carers are routinely invited to attend case conference/care team meetings (though attendance is
infrequent).
• Some providers have their case conferencing meetings with the client present others don’t
• Most providers meet with clients on a monthly or longer basis
• Most Care Coordinators meet with the client to set up and review their goals, go through the care plan with them, and
invite them to case conferences, often based on the client’s self-determination and wishes.
Clients tend to raise service access issues rather than support issues
• Common issues raised by clients (which are similar to those raised by carers) include:
• Housing
• Finances
• Employment
• Availability of clinical AMHS
• Family relationships.
Clients involvement is mixed and they want assistance with service access issues.
PIR clients will want
assistance on service
access rather than
mental health support
Source: Nous Group and Department of Health
nousgroup.com.au 21
Regardless of the recovery method, Care Coordination clients have provided care with no adverse impact on client outcome measures.
BASIS32, HONOS and LSP scores
presented in ~ 3 month intervals
before and after entry into Care
Coordination.
Relative BASIS32, HONOS and LSP at
entry and exit to and from Care
Coordination.
Outcome measures results for Care Coordination clients
0
20
40
60
80
BASIS 32 HONOS LSP
Entry
Exit
0
8
16
24
32
40
48
-12
to -9
-9 to
-6
-6 to
-3
-3 to
0
0 to 33 to 66 to 9 9 to
12
0
8
16
24
32
40
48
-12
to -9
-9 to
-6
-6 to
-3
-3 to
0
0 to 33 to 66 to 9 9 to
12
0
1
2
3
4
-12 to
-9
-9 to -
6
-6 to -
3
-3 to
0
0 to 3 3 to 6 6 to 9 9 to
12
-12 -9 -6 -3 +3 +6 +9 +12
BASIS 32
postpre
HONOS
postpre
-12 -9 -6 -3 +3 +6 +9 +12
-12 -9 -6 -3 +3 +6 +9 +12
LSP
postpre
Entry and exit scores
Sco
re
Sco
re
Sco
re
Pre
cen
t m
axi
mu
m s
core
The data presents the BASIS32, HONOS and LSP scores of clients in ~3 month periods prior to and post entry to the initiative. Data is
presented as the mean ± standard error (number of clients). An improvement in mental health is represented by a decrease in the
score.
Sources: CMI-ODS, Supplementary evaluation data provided by agencies
Time from entry (months) Time from entry (months)
Time from entry (months)
(18) (24) (25)(20)
(25)(38) (23) (20) (123)
(102) (95) (68)(112) (127)
(133) (143)
(96) (99) (100) (100) (110) (80) (88) (59)
(12)
(75)
(53)
(15)(10)
(0) Each PIR
arrangement will
require a common
recovery method/
language
nousgroup.com.au 22
• The staff initially recruited had a high turnover rate as
they did not have the required skillset (local provider
knowledge and relationships, communication and
negotiation skills)
• Providers have tended to appoint staff with:
• clinical qualifications (such as nursing and allied
health) to these roles
• often with cross–sector experience (especially drug
and alcohol or housing)
• preferably with existing relationships with a wide
range of local providers.
• A typical award levels allocated for Care Coordinators is
SACS award SOC 2 year 1-3.
Recruitment of Care Coordinators is hard and getting the right competencies is critically important.
• The required competencies include:
• Tertiary qualifications with experience in the sector
of homelessness, mental health or D&A
• Intimate knowledge of the mental health service
system and inter-relationships between sectors
• Capacity to develop and sustain partnerships with
service providers
• Applied use of recovery models in social settings
combined with a humanistic attitude
• Comprehensive assessment skills and ability to
analyse and bring together a client's previous
history
• Advanced communication and written skills
• High level of interpersonal skills including
assertiveness, diplomacy, negotiation skills, active
listening and the ability to address and resolve
conflict
• Facilitation/leadership skills to chair meetings, lead
teams, and negotiate with other services.
Don’t recruit
clinicians. Recruit
system navigators
who understand
what recovery means
Source: Nous Group and Department of Health
nousgroup.com.au 23
Reduction of use of inpatient beds by Care Coordination clients.
Data presents the difference in use of each bed type based on each client’s historical average use over the year prior to entry to the initiative. Client’s that
have left the initiative continue to contribute to the availability of service hours. The number of clients included in each Collection Period is presented above
each column.
Sources: CMI-ODS, (Note that data for Collection Periods 4 and 5 may be absent from the system), Supplementary evaluation data provided by agencies
Time made available – total (days)
Estimated time of inpatient beds made available by the client group
since entry into the initiative– Care CoordinationTime made available – per client (days)
Collection Period
0
2
4
6
8
10
1 2 3 4 5
Bed days made
available per
client
85 103118
135 152
-500
0
500
1,000
1,500
1 2 3 4 5
PARC
CCU
SECU
Acute inpatient
Sample size
nousgroup.com.au 24
Reduction in use of MST, CCT, and CAT.
Data presents the difference in use of each service type based on each client’s historical average use over the year prior to entry to the initiative. Client’s that
have left the initiative continue to contribute to the availability of service hours. The number of clients included in each Collection Period is presented above
each column.
Sources: CMI-ODS (Note that data for Collection Periods 4 and 5 may be absent from the system), Supplementary evaluation data provided by agencies
Time made available - total (hours)
Estimated reduction of ambulatory services use by the Care
Coordination client group since entry into the initiative. Time made available – per client (hours)
Collection Period
-10
-5
0
5
10
15
1 2 3 4 5
Service
hours made
available per
client
85 103118
135
152
-1,000
0
1,000
2,000
1 2 3 4 5
MST
CCT
CAT
Sample size
nousgroup.com.au 25
Contents
1. Care Coordination v Partners in Recovery
2. Care Coordination insights
3. How partnerships work
nousgroup.com.au 26
• Partnerships have captured the minds of many politicians, policy analysts and practitioners
with the partnership model touted as the best way forward to tackle social problems
• However, the notion of partnerships is not an uncontested idea.
• Judd (2000: 26) notes that partnerships ‘far from bringing coordination to tackling
social problems, partnership working is spinning off into a series of haphazard
initiatives without a clear set of priorities’.
• Hess and Adams (2001: 13) notes that rhetoric of partnerships has become a ‘muddle
of ideas’ in which ‘potentially useful concept is in danger of becoming just another
public policy reform fad’
• A growing body of literature has attempted to bring greater clarity to the confusion
surrounding partnerships
The notion of partnership has gained increasing currency in policy debates in recent years.
Source: The Agora Think Tank (which included the Nous Group)
nousgroup.com.au 27
• A partnership implies a greater sense
of mutuality beyond service
agreements, referral or information
sharing.
• A number of common characteristics
emerge from these studies. These key
elements include:
• Common vision and goals
• Organisations from two or more
sectors
• Shared decision making and
responsibility
• Shared risks and resources
• Address social issue
• Agreed outcome
• Long term
• Autonomy
• New structures and process
• Equality and trust.
Key characteristics of partnerships differentiate partnership from the contractual end of the collaborative continuum.
Deg
ree
of in
tens
ity a
nd c
omm
itmen
t Low- involvement
- engagement
- empowerment
High- involvement
- empowerment
- engagement
Independent
Entities
Coordinated
Effort
Collaborative
Delivery
Integrated
Partnership
RELATIONSHIPS
Collaboration vs competition
• Shared vision• Commitment to
change• Sustainable
relationships• Formal agreements
(MoU)• Interdependence /
Integration• Detailed planning• Role clarity• Financial and
resource commitment• External focus
• New structures and processes
• Commitment of effort• Joint planning• Pooled or shared
resources
• No risk• Protect individual
boundaries• Competition for
funding & resources
Meeting of agencies for information sharing
Referral protocols and case management
Improvements to service systems
Agencies create new structures to address wider issues
• Shared intake or referral tools
• Little joint planning• Little change required
Source: The Agora Think Tank (which included the Nous Group)
nousgroup.com.au 28
Successful, sustainable partnerships create value for each party:
• For those experiencing disadvantage, the value comes from the opportunity to pursue more effective
and more sustainable pathways out of disadvantage.
• In local communities, value can be created in the form of greater social cohesion and community
capacity with the ability to prevent future disadvantage.
• For the not-for-profit sector, the value comes from the opportunity to better serve the disadvantaged
by contributing to services that are innovative, better resourced and better meet the needs of those
requiring them.
• For business, the value can come from an improved corporate reputation in its product and
employment markets, better engagement of existing employees and the opportunity to directly
improve economic returns.
• For the philanthropic sector, the value comes from a greater public return on its investment.
• For government, public value is created by solving problems in partnership and involvement of other
sectors.
The most valued partnerships clearly delivered lasting solutions to the prime beneficiaries – those experiencing disadvantage and their communities.
Source: The Agora Think Tank (which included the Nous Group)
nousgroup.com.au 29
• There are two major challenges:
1. It is easy to underestimate the scale and difficulty of the challenge. The target
population generally experiences complex problems; working to address social
disadvantage can be politically sensitive and partnership design and implementation
is complex.
2. Partners are typically diverse. The value that each partner is seeking to create may be
at odds with other and each partner will certainly bring a different culture,
organisational values and appetite for assuming risk.
• Successful partnerships do not underestimate the challenge, and work hard to harness their
diversity as a strength of, rather than a constraint to, their partnership.
Organisations from across all sectors have expressed an enthusiasm to partner, but can under-estimate the challenges.
Source: The Agora Think Tank (which included the Nous Group)
nousgroup.com.au 30
Partnerships designed to address disadvantage share the common ingredients such as shared vision, trust, respect and honesty.
These challenging partnerships have seven distinctive elements:
• Passionate leadership – A connecting passion among key individuals, complemented by strong support from organisational
leaders. The leadership roles and responsibilities are agreed and clearly defined.
• Flexible can-do mindset - There is flexibility and willingness to work around unforeseen barriers and difficulties. The funding
provided is flexible to accommodate solutions that are innovative and address a real need. Partners come seeking opportunity
rather than to overcome a problem. The values of openness, trust, honesty and transparency are agreed, shared and lived. It
is helpful where the partnership has grown from a pre-existing relationship where mutual trust and respect has already been
established.
• Value creation focus - Delivers value to each partner commensurate with their effort and risk, and avoids having low input
partners. There are agreed and defined outcomes, milestones, strategies, structures, decision making frameworks and
operating processes. The risks and the benefits are shared. All partners as members of the community participate in the
design of the solution not just the delivery.
• Intelligent resource usage - Draws on the distinctive capabilities, resources and business systems of partners. There are
dedicated and appropriately skilled resources, individuals or organisations that provide facilitation/brokerage support to
overcome some of the cultural barriers that can exist between sectors. There is equal contribution from partners/community
members and all contribution is respected.
• Loaded for success – designed for early wins and clear, reinforcing feedback on performance.
• Partnership investment - There is investment in the partnership and the solution. This includes time, energy, funding and
strengthening the relationships and connections between partners. There is willingness from all partners to engage in mutual
learning. The learnings are available and easily accessible to others.
• Sustainability – There is a persistence and commitment that develops beyond the original passionate few. The outcome is
sustainable because sustainability has been incorporated into the design of the solution. The time frames are medium to long
term.
There is a lot of research on what makes a good partnership. This is our take…
Source: The Agora Think Tank (which included the Nous Group)
nousgroup.com.au 31
http://www.agorathinktank.org
http://thepartneringinitiative.org
For more information on parternership….