Edward Cornick

Due to the complexity of the system the NHS operates in, it is perhaps unsurprising that when discussing change or tackling a problem, we tend to obsess, or at least first resort to, examining systems, structures and process. But while these are important, if we think about our day to day to working lives, more often than not what makes things work, at work, is the quality of relationships we have with individual colleagues and stakeholders. When these are good, problems are shared and addressed together; when they are bad, even tiny issues can seem insurmountable.

More often than not, what makes things work is the quality of relationships we have with individual colleagues and stakeholders

For example, if we consider what is perhaps the biggest issue that the NHS faces at the moment - funding - we can see the huge value of personal capital. Securing the extra £8bn from the last comprehensive spending review for the NHS was widely attributed to the close working relationships between those at the top of NHS England and the then chancellor George Osborne. But now, since the change of leadership at the treasury and number 10, we see robust messaging on the possibility of any extra funding coming to the NHS, with directions to get its house in order like other government departments. This changing relationship has moved the NHS from being an ‘our’ problem to a ‘your’ problem, and demonstrates quite clearly the effect of people rather than institutions in shaping decisions.

But it is not just at the very top of the system that relationships hold such sway. I have given some thought to this recently when I have been to many sessions across numerous healthcare conferences. The topics, as ever, are diverse - from commissioning, quality, budgeting, staffing and integration. However, at some point someone on the panel, usually while describing their potential solution to any of these issues will mention “of course, none of this works unless the relationships are right”. At which point, everyone in the room tends to nod sagely before the conversation moves immediately onto the detail of the systems, structures and process in question. 

Look across many of the meaty issues affecting the NHS, getting relationships to work is at the heart of all of them

But what if getting the relationships right is the detail - if none of what is being discussed really functions without relationships working, shouldn’t that be the starting point?

Look across many of the meaty issues affecting the NHS, getting relationships to work is at the heart of all of them. Reducing conflicting regulation on providers is hugely contingent on central bodies having close and productive relationships. Reconfiguring services locally will not happen unless local people feel their concerns are listened to by trusts. Integrating care hinges on organisations across local health economies putting aside their institutional views of the world to collaborate together.

Therefore, throughout the Relationships conference strand session, we look to provide some of the detail that can help providers address the common relationship issues that underpin the delivery of current policy. It sets out to provide practical advice and solutions in relationship building, from external experts and those who have been there and done it.

Find out more about the annual conference and exhibition strand programme, and book your place to join us in Birmingham on 29-30 November