In an organisation such as the NHS. This concurs

In this
assignment I am going to outline what workplace identity is, what partnership
working is and then explain how partnership working may threaten workplace
identities.  I am going to draw on
specific examples.  Following which, I am
going to suggest how a manager or leader might act in such situations by
outlining potential strategies or tools that could be used to resolve and
improve partnership working and team identity. 
This assignment will close with my conclusion.

 

In my opinion, workplace identity is an
environment where people feel valued about their contribution and opinion
regardless of their gender, priorities, class or individualism.  A clearly defined workplace identity is where
a team and its members have a clear strategy they work towards whether that is
for a greater purpose or an organisation such as the NHS.  This concurs with Halsam and Van Dick (2010)
who suggest that having a shared sense of social identity is a positive,
whereas without it, there is an association with stress and anxiety.

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If I were to look at Anton Obhozler’s (1994) work
on understanding workplace identity, I would agree that there needs to be a
clear picture of the primary task (the vision). 
This is a similar to team working. 
As an example my team’s objective is to turn health data into meaningful
information for NHS service managers and patients. 

 

According to the Kings Fund, (2011) understanding
workplace identity is of fundamental importance as it supports better care for
patients.  People feel a sense of
security when they are part of an identified group.  When people feel a sense of belonging and
importance there is a positive effect on patient care.  A lack of identity and team work results in
poorer patient care, as evidenced in the Bristol Royal Infirmary Inquiry (2001,
p20).  The inquiry highlighted how many failed to
communicate with each other, and to work together effectively for the interests
of their patients.  The underlying
conclusion being a lack of leadership and teamwork.

 

Having
the correct workplace identity is also important, for example in the Winterbourne review (2012, p.8) there was an embedded culture of abuse where its
management allowed it to flourish.  It is
imperative that a team’s identity adds value to the overall objective of the
NHS, i.e. better patient care.  As Jasmine’s
example (Mackian, Russell & McCalla, 2013. p.142) suggests not all
workplace identities are meaningful.  In
summary, having a valuable workplace identity is dependent on the existing
culture. 

 

Identities
can be damaged by change.  It is now more
difficult to have a lasting team and identity due to increasing demands and
limited resources.  My Health Board has
recently merged which brought about a great deal of change.  This affected my team’s identity because we
had new members we had to integrate with and also a wider remit of work to
undertake.  This concurs with (Bauman,
1998, p.27) who say only in relatively rare cases can a permanent identity be
defined.  Ahlgren (2010) suggest
that workers identity can change with time and this is due to the continuous
interaction of the worker with differing work practices and activities. This is
somewhat true in the NHS where there are mergers, partnerships, and staff
changes, differing targets, seasons and patient acuity.

 

I have experienced top-down management
structures.  An example being when I
attempted to be innovative with a report deadline template.  I added more prescriptive instructions.  However this was seen as unnecessary and I
was explicitly told to, leave it as it was, and do it in the same way as
before.  This left me feeling vulnerable,
criticised and unproductive.  My former
line manager wouldn’t even take on one improvement I’d suggested or listen to
why I had suggested a change.  I experienced
workplace dis-identification in very much the same way Jasmine did in case
study 6.1 (Mackian,
Russell & McCalla, 2013. p.142).  In
this situation, I believe my former manager struggled with the prospect of change.  If the roles were reversed I would endeavour
to have a conversation outlining my thoughts with a view to opening up a
dialogue and exchanging thoughts so that a mutually agreeable solution could be
agreed on.  This way, both sides would be
happy with any changes that did or did not occur.

 

Being
in a partnership can be challenging due to the different individuals within it,
i.e. patients, carers, Doctors and administration staff.  The different skill mix and back grounds add
a level of complexity that isn’t exhibited within individual teams.  These complexities alongside the additional
requirement to build a successful team can add towards threatening
identities.  Ward (2003) suggests that
building a team is an ongoing project, not an intermittent intervention.  To me, this suggests that team identity
always needs work and if that team is then put into a partnership even more
intervention and support is required.

 

In my
view partnership working is where people (or teams) work outside their normal
working environment alongside other people from different organisations with
the sole purpose of achieving a task (or commitment) that they would not have
been able to achieve on their own. 
Sullivan and Skelcher (2012) add that there must be a positive outcome
and a desire to overcome inflexibilities of boundaries.  Hudson et al, (1998) outline 4 broad steps
that are taken in order to form a partnership. 
Initially a team is working in a silo with no partnership, following
which there is an encounter, then communication, collaboration and finally
integration.  According to Hudson et al,
(1998) this integration looses an organisations individual identity.  Other researchers describe the process using
terms such as depth (the sharing of information and communication) and breadth
(the number and level of organisations engaged).  The depth of the partnership relationship is
one step below a formal merger and one step above jointly managing a project.  Either way integration requires a shared
commitment from all parties (teams) involved in creating a partnership.

A
clearly defined workplace identity is where a team and its members have a clear
strategy they are working towards whether that is for a greater purpose or an
organisation such as the NHS.  This
concurs with Halsam and Van Dick (2010) who suggest that having a shared sense
of social identity (common values, purpose and shared norms) is a positive
(material, emotional and intellectual support, whereas without it there is an
association of stress and anxiety.  ‘Huxham,
1996’ (Mackian,
Russell & McCalla, 2013. p201) also suggests that without a clear idea of what
is to be achieved, partnership working will fail. 

Without a lack of understanding and a clear
purpose, partnership working will not meet the goal it has set out to do.  This also sits neatly within the ‘four building
blocks of a fully rounded caring manager’ (Mackian, Russell & McCalla,
2013. p7).

Without a goal and an understanding of the
context the partnership will likely fail.

If I were to look at Anton Obhozler’s (1994) work
on understanding workplace identity, I would agree that there needs to be a
clear picture of the primary task.  This
is a similar to team working.  As an
example my team’s objective is to turn health data into meaningful information
for NHS service managers and patients. 
This aids decision making by service managers to ensure best quality,
safety and efficacy of care.

 

One of
the reasons partnership working can threaten workplace identities is due to
individuals or teams going from being a big fish in a small pond to a little
fish in a big pond.  Literature published
on failed partnerships suggests that power and hierarchy are one of the
contributing factors of failure.  Feelings
such as a lack of power, a reluctance to change, a lack of vision can all
become forces that add to a partnerships failure.  Some individuals believe they should lead due
to their pay grade or recent success. 
While others believe they have limited scope to add value as they aren’t
even paid by the organisation, i.e. voluntary workers.  

 

In the
past I have facilitated a service user feedback partnership meeting.  The partnership had varied members including
multi-disciplinary clinicians, voluntary personnel and service users.   It was clear from the outset that on
particular voluntary members felt they were a token gesture member of the group.  They would consistently send apologies and
not contribute any verbal opinions when in attendance.  At one of the scheduled meetings the chair
made a clear effort to include this person and assure them how important their
contribution was.  This behaviour (I
believe) was one of the contributing factors to the partnerships success.  I measured its success by the outcome, which
was implementing a family visiting room for detained Mental Health patients.  

 

It
isn’t always as easy to measure how successful partnership working is and my
example above could be considered subjective rather than objective.  Along with power and status a third element
can affect partnership working, namely communications issues where different teams
use different jargon such as team specific acronyms.  In my current role I produce monthly
performance reports which are published for the board, patients and wider
public.  I regularly edit the narrative I
receive so that it’s less technical, more straightforward and can be understood
by the lay person (i.e. I detail acronyms). 
As discussed in our text books (Mackian, Russell & McCalla, 2013.
p199) technical language and expert knowledge have been traditionally been used
to create authority and power for some individuals. 

 

When
forming a partnership a Manager/Leader should ensure dialogue is encouraged
between individual members and teams. 
The dialogue needs to outline the positive outcome that could be achieved
with everyone working together.  In that
dialogue the overall vision needs to be clear. 
The conversations should include concerns raised and potential issues
people feel need airing.  A
Manager/Leader should ensure that everyone feels like they have an equal voice.  They should eliminate barriers to
participation, for example ensuring people aren’t prevented from attending when
they can’t afford transport.

Perhaps
the Manager/Leader may consider open space meetings which allow people to
convey their feelings in a constructive yet free manner, without recompense or
argument.

 

A
Manager/Leader could hold a workshop to allow people to express their
concerns.  The workshop would be a
specific forum to improve the identity of the Partnership.  Sometimes issues could be raised that are not
solvable but at least the issue is aired and helps the person with the concerns
feel they have been listened to.  Being
listened to and valued is said to be one of the main attributes to being happy
at work.

 

A
Manager/Leader could use a ‘stakeholder mapping tool’ (Mackian, Russell &
McCalla, 2013. p105).  A stakeholder
mapping helps identify those who have influence in a particular project.  It would ensure that the correct people are
engaged in the correct way.  It could
make a positive impact on a partnership’s identity as a whole and also protect
individual and team identities.

 

Helping
people to embrace change is another step a Manager/Leader could proactively
implement.  Being proactive is said to be
an important trait of an effective leader. 
By being proactive a Manager/Leader could facilitate members utilising a
variety of tools to assist in the change process.  One method that could be used was developed
by ‘Kurt Lewis, 1958’ (Mackian, Russell &
McCalla, 2013. p96) who advises splitting the approach to change into
three themes; unfreezing, moving and refreezing.  This stepped approach helps people piecemeal
the process in a manageable format.

 

Later
on, a more in-depth methodology was developed by ‘John Kotter, 1996’ (Mackian, Russell & McCalla, 2013. p96).  This process has 8 steps which can be used as
headings to break down the change process, namely to create; urgency, a
coalition, a vision, clear communication and short term wins.  He advises to build on change and finally
embed (anchor) that change into the partnership.  If I were to assimilate John Kotter’s process
to my own experience I would do so as follows:

·        
Urgency:
Patients have nowhere private to have family visit;

·        
Coalition:
The Ward are looking after the patient and not able to implement this on their
own;

·        
Vision:
Patients, Carers, Staff and visitors (especially children) would be happier and
experience better patient care;

·        
Clear
communication: Meetings, papers, inclusion and dialogue;

·        
Short
Tem wins: Getting finance or getting planning permission;

·        
Build
on change: What other improvements can this partnership implement?

·        
Embed:
Continue partnering for ongoing improvement initiatives.

 

Other
tools that could be used are the stakeholder mapping and ‘SWOT’ analysis
(Mackian, Russell & McCalla, 2013.p.104) tool which helps identify those
who have influence in a particular project and SWOT analysis identifies
strengths and weaknesses, opportunities and threats.

 

Whether
during a workshop or at a meeting a Manager/Leader should spend some time
outlining the partnership’s goal.  This
is an important aspect to ensure a partnership’s success.  The goals may change and grow when the
partnership develops but a Manager/Leader should always aims to do things more
efficiently.  This is never more
important under the current financial climate of the NHS.  The ‘goal setting tools’ (Mackian, Russell
& McCalla, 2013. p.17), such as SMARTER, WISE and DIM, could be utilised to
ensure the vision is robust and clearly stipulated to everyone concerned.  Each goal setting tool (framework) has its
limitations and users need to decide whether to utilise all or some
aspects.  For example the extended
SMARTER (Smart, Measurable, Achievable, Relevant, Time bound, Engagement and
Reward) helps improve sustainability and outlines the end goal (the
reward).  But a manager/leader
(especially a Transformational Leader) may want to inspire and excite
members.  In which case the WISE
(Written, Integrative, Synergistic and Expansive) framework may be more suitable.   A
Manager/Leader may consider using the SMART goal for individuals as it
facilitates the change management process (a team integrating into a
partnership) and bring it all together to create a WISE goal setting tool for
the entire partnership group.  The skills
required deciding which tool would work best for individuals, with Authentic
and Situational leadership skills.  A
tool that incorporates flexibility is DIM (is the goal demanding, innovative
and moveable). 

 

Despite all the difficulties Partnerships can
bring, working together and in partnership is proven to be better for the
patient.  To be a success it is
indicative to have clear leadership and vision whilst also balancing the
requirements and aspirations of individual teams and members.  A Manager/Leader should correctly demonstrate
all traits listed under each of ‘the four building blocks of a fully rounded
caring manager’ (Mackian, Russell & McCalla, 2013. p7).  They should lead by example; manage
relationships, environments, goals, quality and aspirations.  An individual with authentic and situational
leaderships would do well in this situation. 
Being an authentic leader would promote good and honest relationships
with partnership members as they are more concerned about people than the
prize.  A situational leader would also
be a good fit as they can adapt to the variety of skills and personalities
within the group.

Without
the interventions above, it is likely that a partnership will fail, or worse
still cause harm to a patient.  Research
suggests that effective teamwork in healthcare is linked to a reduction in
medical errors and an increase in patient safety,(Manser, 2009) it is also
known that medical errors can be linked to poor teamwork.  The Bristol Royal Inquiry (2001) recommended
that all healthcare professionals should have education and training on the
idea of partnership between professionals and the patient. 

 

In
summary creating partnership is a change and as quoted by ‘Iles, V. 2006’ (Mackian, Russell & McCalla, 2013. p95) as
being able to judge the different approaches (limitations and strengths) when implementing
effective change.