As someone born in Somerset and who still has family there (not to mention a lifelong love of cheddar cheese) I may be a little biased when I say the county has much to teach us. But I’m genuinely excited about our work with The Richmond Group of Charities on lessons from their practical work on health and care collaboration in Somerset.

In short: The Richmond Group set out to explore what cross-sector collaboration in health and care looks like in a particular place. The work itself aims to achieve better outcomes for patients and reduced demand for services across Somerset. And NPC has captured learning from the initial stages of the project, which explored what new ways of working across sectors in a specific geographic area could look like in practice.

While the unique context for the work is important, the wider charity sector can learn much from The Richmond Group’s collaborative work in Somerset. Three things stand out.

Putting proper resource behind bringing people together is powerful

Our research showed how a body like The Richmond Group can act as a ‘bridging organisation’, forging connections across sector and geographic boundaries.

It did this by appointing local and national programme managers who sought to understand and close the gaps between disparate actors and agendas. The local programme manager was given a relatively open brief to gather data on community needs and assets, and to scope out the potential for cross-sector collaboration.

This flexible way of working led to conversations and connections that would not have happened otherwise. Our interviews found that The Richmond Group brought people together outside their normal ways of working and helped to find common ground. The local programme manager worked creatively across sectors and was able to navigate differences, open up conversations, and build relationships.

There are significant systemic challenges to this approach

This work also shows just how challenging it can be to collaborate in a particular place. Existing tensions and systemic barriers threaten to overwhelm new ways of working. As many people trying to change the status quo have found, ‘the harder you push, the harder the system pushes back’.

In Somerset, collaboration was constrained by commissioning models that promote competition between charities for limited pots of funding. Some smaller local charities were suspicious of The Richmond Group’s motives, fearing that they wanted to take over contracts. And collaboration across sectors was limited by cultural differences, strict purchaser-provider relationships, and confrontational mechanisms such as haggling over money.

Focusing on outcomes helps us move beyond organisational self-interest

Successful place-based collaboration means overcoming these systemic barriers and managing tensions between organisations. It requires a mindset shift to focus on outcomes that could be achieved by working together, rather than for individual organisational interest.

The Richmond Group’s work supported people to step outside their organisations and look at issues and solutions across Somerset. They mapped Somerset’s population, health and care systems, pressures, and any partnerships already underway. This led to a concrete proposal to roll out social prescribing across the county in order to improve health and care outcomes.

While it is too early to assess the Somerset programme’s success achieving its ultimate goal—improving people’s health—there are encouraging signs that collaborative ways of working are starting to bear fruit. Charities and statutory leaders report better understanding of each other’s priorities, motivations and pressures.

Alongside the social prescribing proposal, the programme has helped to inspire smaller-scale collaborative projects. These include: a marketplace event for charities to better understand each other’s work; and referrals between different organisations.

These early successes remind us that just because collaboration is difficult does not mean it’s not worth it. Indeed, the collaborations with the highest impact are often those that bring together ‘unusual suspects’ and draw value from their differences. NPC’s State of the Sector research tells us that charities across the country are looking to collaborate more in the future. Our research with The Richmond Group suggests they can learn much from the experience of Somerset.


Take a look at our work with the Richmond Group, and share your thoughts via Twitter @NPCthinks or drop us a line at info@thinkNPC.org.

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