Collaboration or Conflict?

Working with health and care organisations across the country, over the last couple of years my Healthskills colleagues and I have experienced a welcome enthusiasm and commitment to embrace a more collaborative way of working. This is in contrast to the often competitive environment that leaders have found themselves between organisations, however inadvertently, and which occasionally has hindered achieving goals, prevented successful service redesign and encouraged silo working.


Whether you are Clinical Director in the new Primary Care Networks, trying to operate as a collaborative leader across your ‘place’ or borough, or indeed leading an emerging Integrated Care System, ditching a tribal mentality and embracing shared goals and common purposes with others can be challenging.  Where do you start if you need to have what you might think will be ‘difficult conversations’ and develop a more trusting, productive relationship with system partners?  Here are five steps that we have found incredibly useful over the years to help to get you started:


Step 1: Prepare by thinking through the situation

Ask yourself:

  • How have you ended up in this situation?
  • What has happened? What is happening now?
  • What have you each contributed to the problem?


Step 2: Check your purposes

It is important to take time to consider what your real motives are for having this conversation:

  • Is it to coerce or punish someone?
  • Are you trying to educate or protect?
  • Do you genuinely want to move from antagonism to mutual benefit?


Step 3: Start with congruence

Try to identify and share areas of common ground, similarity of views, values, behaviour and crucially outcomes – this will create a platform for dialogue.

What could be your common purposes and congruent goals?


Step 4: Explore the situation and key issues

The following points may help:

  • Emphasise the value of each contribution
  • Actively listen to understand their perspective on what has happened previously and what impact this has had on behaviours
  • Try to unravel how the two (or more) of you got to this place
  • Adopt a flexible position, and be open to new information


Step 5: Problem solving and agreement to action

  • Try to find solutions that meet each side’s most important concerns and interests – relationships that always go one way rarely last
  • Contract what each of you will do differently, and identify what the positive consequences will be
  • Agree what the negative consequences are of not doing this
  • Clarify what you will each do now and how you will review progress

Moving from adversarial working relationships to those based on trust and mutual respect takes time and confidence, but even starting out with these five steps can help you progress surprisingly quickly.

For more information about how our Leadership Coaching can help you and your teams click here.