Promoting partnership working in the NHS

About SPF

Social Partnership Forum

The Social Partnership Forum (SPF) brings together NHS Employers, NHS Trade Unions, NHS England, Health Education England (HEE), NHS Improvement and the Department of Health to discuss and debate the development and implementation of the workforce implications of policy.

 SPF at a national level

The national forum was first set up in March 1998, after recognition of the positive contribution that partnership working can make toward improving patient care by actively involving employers, employees and their trade unions in continuous dialogue around the entire decision-making process.

Since then, a growing body of evidence has emerged  to demonstrate that effective staff engagement is essential in creating a positive culture of safe, compassionate care and is strongly linked to improving patient outcomes and organisational performance. Read the evidence in our case studies section.

The primary aims of SPF are to:

  • contribute staff side and employer perspectives to emerging policy at a formative stage
  • improve policy development and implementation by feeding in ideas on workforce implications
  • promote good practice in relation to partnership working and effective communication between partners.

SPF does not discuss the contractual arrangements for NHS staff as this is carried out in the national NHS Staff Council which has overall responsibility for the Agenda for Change pay system.

For an overview of the work and priorities of the national SPF you can download the national SPF factsheet. This is a useful resource for sharing at meetings, events and conferences.  

An updated SPF Partnership Agreement has been published to reflect more closely the current healthcare system and its priorities.

The partnership now includes NHS England, Health Education England, and NHS Improvement alongside the historic partners - Department of Health, NHS Employers, and NHS Staff Side (trade unions).

The new Partnership Agreement sets out the framework through which the partners commit to work collectively to tackle the biggest healthcare priorities and challenges.

Signed by Ben Gummer, SPF Ministerial chair, Simon Stevens, Ian Cumming, Jim Mackey, Charlie Massey, Danny Mortimer, NHS Employers SPF chair, and NHS Staff Side chair Christina McAnea (Unison), with a foreword by the Secretary of State for Health, the agreement sets out shared values and principles for effective joint working.

These include:

  • Trust and mutual respect
  • Openness, honesty and transparency
  • A culture of no surprises

SPF Signing

Christina McAnea, UNISON, said “The NHS trade unions welcome the revised SPF Partnership Agreement and the shared commitment to support the NHS workforce to deliver high quality health care services for all.”

Danny Mortimer, NHS Employers added “NHS Employers welcomes the new SPF Partnership Agreement, bringing together the various parts of the NHS with the Government, front-line employers and staff representatives.

The agreement confirms again our shared values and principles for effective joint working ensuring we better support our people, and thereby our patients.”

Alongside the new agreement, the SPF Members Handbook has also been updated and published.

SPF sponsored HPMA award for partnership working
SPF actively encourages partnership activity through the sponsorship of the Healthcare People Management Association (HPMA) award for partnership working with trade unions, to identify, reward and promote excellent partnership working.

Partnership working – good practice
SPF continues to promote partnership working by gathering examples of good practice. Case studies are published on the SPF website evidencing the positive outcomes achieved locally through partnership working where employers and trade unions work together to agree joint solutions to issues affecting the workforce. This process helps to ensure that staff are actively engaged, supported and consulted in the workplace.

SPF Stocktakes

Building on Partnership - SPF Stocktake 2015, was an independant review of the National SPF's effectiveness since new ways of working were put into place in April 2013.

The national SPF has been particularly keen to support the continued development of regional SPFs. The 2013 and 2014 annual SPF stocktakes focused on supporting regional SPFs following transition and to nurture greater linkages between the national SPF agenda and those of the regions. 

As a direct result of these stocktakes, regional SPF representatives now attend national SPF meetings on a rotational basis, and  members of the national SPF attend regional SPF meetings.  This  has helped to foster better two-way communications and connectivity.

Redeployment of staff
Regional SPFs have published a Memorandum of Understanding (MOU) on redeployment of staff, which sets out the principles across the  four regions whereby NHS employers can sign up to wider redeployment of staff who are at risk of redundancy.


The SPF is committed to working together to support the NHS to deliver its priorities and to improve outcomes for patients, through engaging the NHS workforce in policy development and implementation.

The SPF is keen to support the Secretary of State and Ministers to deliver priorities that have workforce implications, in particular those around supporting staff to deliver safe, compassionate care for patients’ 7-Days a week.

In a communication to regional SPFs, the national SPF set out its priorities for 2016/17 detailed below and is working on these as follows:

  • Service transformation
  • Service delivery
  • NHS culture and staff experience.

Service transformation and delivery

SPF has been working closely with system partners, including the strategic office of the NHS Forward View Board, around development of Sustainability and Transformation Plans (STPs) and New Care Models arising from the Five Year Forward View and the Shared Planning Guidance. 

As these policies move into the implementation stage, the SPF is committed to support the service in transforming these plans into reality.   

SPF has recently been asked to establish a 7-Day Services subgroup to look at the workforce issues and implications of moving to a 7-Day NHS. 

NHS culture and staff experience

At the behest of ministers, the SPF has been developing and leading a programme of work to tackle high levels of bullying and harassment in the NHS, as it can have a negative impact on both staff health and well-being and patient safety and outcomes. Initially, the SPF contributed to a roundtable event hosted by the Secretary of State, but more recently, the SPF through the Workforce Issues Group (WIG) has taken a lead on the work and is now developing a campaign including agreeing a single narrative, coordinate existing resources, tools and good practice that can be promoted and be socialised at events and meetings. 

SPF achievements include:

  • SPF Partnership Agreement has been refreshed and now contains a foreword from the Secretary of State for Health, as well as an introductory statement by PS(CQ), Ben Gummer and has been signed by NHS England, Health Education England, NHS Improvement (TBC), NHS Staff Side, NHS Employers and the Department of Health. 
  • New Fair Deal - the WIG produced FAQs, guidance and supported a national event to increase the understanding of New Fair Deal in the NHS. Under New Fair Deal an employee transferred out of the NHS to an independent provider is able to remain a member of the NHS Pension Scheme as long as they continue to be employed on the transferred service or function.
  • NHS Pension ACCESS – WIG, working with Her Majesty’s Treasury, developed the NHS Pension ACCESS provisions, which came in April 2014 and the SPF produced and made available on its website, guidance on the ACCESS arrangements. The ACCESS arrangements give independent providers of NHS clinical services the opportunity on a voluntary basis, to allow their staffproviding NHS funded services, to access the NHS Pension Scheme. The SPF has also carried out a review of access to the NHS Pension Scheme for independent providers in December 2015, which received ministerial backing in April 2016.
  • Flu Fighter Campaign - the SPF continues to support the “Flu Fighter” campaign which encourages uptake of the seasonal flu vaccination among NHS staff in order to protect patients and staff from the virus and to reduce staff sickness absence during the busy winter period.
  • NHS Constitution - the forum played a significant role in helping to develop and refresh the NHS Constitution, particularly in relation to the pledge on staff engagement. The Handbook to the NHS Constitution cites the SPF as one of the primary vehicles for achieving effective staff engagement through partnership working. More recently the SPF, particularly the regional SPFs were involved in promoting the Constitution through a social media campaign which had positive results. 
  • The Care Quality Commission (CQC) has been working with the national SPF to inform the development of its new inspection regime. Given the compelling evidence of the link between staff engagement and patient outcomes and organisational performance, SPF has been advising CQC on the best way to incorporate staff engagement and partnership working as part of its inspection regime. The action note from the last meeting is available here.
  • Francis Inquiry into Mid Staffordshire - the SPF Francis subgroup was set up following the Francis Inquiry into the failings at Mid Staffordshire Hospitals NHS Foundation Trust. The Francis Inquiry report ’Hard Truths: the journey to putting patients first’ requested that the SPF produce guidance to support staff engagement in the NHS. The guidance builds on the six key messages identified in Hard Truths to help the NHS build on its strengths and develop the positive working environments that ultimately benefit patients.
  • Whistleblowing & raising concerns - SPF continued to play an active role in supporting the work of the Whistleblowing Helpline campaign and fed in to the independent review ‘Freedom to Speak Up’ led by Sir Robert Francis QC.  This policy aims to create an open and honest reporting culture in the NHS, which is vital to ensure the working environment for staff is improved, which in turn will be beneficial for patient outcomes.
  • Case Studies – The SPF continues to develop and showcase the positive outcomes that can be achieved through employers and trade unions working together. The SPF actively encourages partnership activity through various activities including the sponsorship of the Healthcare People Management Association (HPMA) award for partnership working with trade unions, to identify, reward and promote excellent partnership working.
  • An SPF Infographic is now available on the SPF website, which shows the organisational structure and the relationships between the SPF groups including regional SPFs.


Membership of the national SPF includes representatives from the following organisations:

Department of Health, NHS England, Health Education England, NHS Improvement, NHS Employers (and representatives from individual employing organisations) NHS Trade Unions (including British Orthoptic Society, British Association of Occupational Therapists, British Dietetic Association, British Medical Association, Chartered Society of Physiotherapy, Federation of Clinical Scientists,GMB, Hospital Consultants and Specialists Association, Managers in Partnership, Royal College of Midwives, Royal College of Nursing, Society of Chiropodists & Podiatrists, Society of Radiographers, Trade Union Congress, UNISON, Unite the Union)

From 2014 the Wider SPF meets three times a year. It is chaired by Philip Dunne MP, Minister of State for Health.

Conduct of meetings 

Items may be placed on the agenda by any of the parties. secretariat arrangements are led by the DH, who liaise with key contacts from NHS Trade Unions, NHS Employers, HEE and NHS England. All partners are encouraged to use the forum to showcase effective partnership working in line with the aims of the forum.

The SPF chairs manage business and maintain proper conduct of meetings and are responsible for ensuring that individual members uphold the partnership principles and the co-operative spirit of the forum.

To help facilitate effective working the partners agree to the following:

  • every effort will be made to provide information in good time for discussion and/or consultation
  • all parties will undertake to provide a considered, co-ordinated and timely response to issues on which their views are sought/on which they are consulted
  • all parties to respect confidentiality where that is required or requested; and otherwise to conduct their dialogue openly

Each of the five partners are responsible for nominating their representatives; six employer representatives, representatives from all recognised NHS Trade Unions plus an observer from the TUC, five Department of Health representatives, two NHS England and one member from Health Education England. Each of the three Devolved Administrations also has a seat on the Wider Group, plus additional stakeholders from ACAS, NHS Confederation, Business Services Association and Skills for Health.

Minutes and communications 

All meetings are minuted. Joint key communication from the Wider Group meetings are agreed by all partners and published in the SPF Bulletin and on the SPF website.

Further information 

The Partnership Agreement includes a letter of introduction signed by the previous Secretary of State and sets out a framework for partnership working. It describes the principles of partnership working, processes and structures linked to the partners’ shared goals and objectives.

In addition a members’ handbook was introduced which sets out the role of members and how they can support the aims of the SPF.

From 2014, the former SPF Steering Group has been replaced by a new Strategic Group. This reflects the need for a streamlined forum in which increasingly robust debate may take place between the partners about emerging policy where there are significant workforce implications.

The Strategic Group remains fully within the auspices of the existing SPF governance arrangements and will be co-chaired by NHS Employers and NHS Staff Side but without the requirement for a Minister to be present.

SPF Strategic Group evolved from discussions between existing and new system partners (specifically NHS England and Health Education England) with the overall intention of ensuring SPF’s continued fitness for purpose in light of the changes to the healthcare system in April 2013. This is consistent with the ongoing commitment in the existing SPF Partnership Agreement.

Membership of the Group is significantly smaller than the former SPF Steering Group, comprising the following:

  • NHS Employers – Danny Mortimer (co-chair), plus two NHS employer reps
  • NHS Staff Side – Christina McAnea, Unison (co-chair), plus one rep from each of BMA, RCN, RCM, CSP
  • DH – Charlie Massey
  • NHS England – Stephen Moir, plus one other Director
  • HEE – Lee Whitehead

Terms of Reference have been agreed and a draft strategic workplan has been produced, which will constantly evolve to ensure the Group continues to focus on the most pressing and complex challenges facing the NHS and to seek and contribute partnership solutions to those issues, wherever possible.

The Strategic Group, which will meet four times a year, may task or commission regional SPFs, existing SPF subgroups or new working groups to undertake actions or wider pieces of work emerging from its discussions.

It will be supported by the existing SPF Secretariat and the Group will provide regular updates both to the Wider SPF meeting – through a standing item on the agenda - and to partners’ via individual networks.

To note - the SPF Wider Group meeting, with a Minister continuing to chair, will remain as before but its frequency will be increased from two to three times per year. This will ensure that the Wider SPF has an increased opportunity to discuss and debate relevant issues and to fulfill its assurance role. Membership of the Wider Group will remain as before.

The SPF has a dialogue with the Care Quality Commission (CQC), to enable social partners to inform and support the work of the CQC where it impacts on the workforce.

Read the agreed meeting arrangements which are in place to facilitate engagement between the SPF and CQC.

Action notes from previous meetings between the SPF and CQC are listed below.

September 2016

February 2016

April 2015


SPF Strategic Group

Update on 7 day services - SPF Strategic Group - June 2014.

NHS England finance update - SPF Strategic Group - June 2014.

CSU update - SPF Strategic Group - June 2014.

VBR update - SPF Strategic Group - September 2014.

Update on 7 day services - SPF Strategic Group - December 2014.

The future NHS - NHS England - SPF Strategic Group - February 2015.

Update on 7 day services - SPF Strategic Group - June 2015.

Brexit presentation, Kate Ling, NHS European Office - SPF Strategic Group - September 2016.

SPF Wider Group

Employee Engagement and Patient Outcomes - Michael Wests presentation to SPF Wider Group - March 2014.

Time to Change - Presentation from Sue Baker at Wider SPF - March 2014.

Workforce Race Equality Standard (WRES) - Presentation from Roger Kline and Yvonne Coghill - July 2016.

SPF proposals to tackle Bullying and Harassment in the NHS - Update paper - July 2016.

NHS Apprenticeships - Alan Robson, Department of Health - October 2016.

National Guardian update - Dr. Henrietta Hughes, National Guuardians Office - October 2016.

New Care Models update - Clare Simpson, NHS England - October 2016.

2016 NHS Staff Survey Results - Clare Enston, NHS England - March 2017.

Flu fighter campaign update paper - March 2017.

Freedom to speak up/Freedom to improve - West Suffolk NHS Foundation Trust - March 2017.

SPF Stocktakes

2015 SPF annual stocktake report

2014 SPF annual stocktake report

2013 SPF annual stocktake report

NHS England

The NHS Belongs to people - A call to action

The Forward View into Action - Planning for 2015/16

The NHS Five Year Forward View: New Models of Care Programme