Promoting partnership working in the NHS

How we do partnership

The SPF recognises what a powerful tool partnership working between employers, policy makers and trade unions can be, and how it makes a real difference to patient care and influences employment practice in healthcare and beyond. The how we do partnership hub contains details of the growing body of evidence on the benefits and importance of true partnership working. You will also find useful case studies, tools and resources to support successful partnership working.

Although social partnership arrangements have been in place since 1998, a refreshed approach to partnership working was needed following the major announcement on transforming community services in 2006. The announcement caused concerns and difficulties for stakeholders in the NHS for England. The concerns were addressed by Patricia Hewitt the then health secretary and the ensuing discussions, facilitated by the TUC, led to an agreement by the end of that year which established the SPF. A key principle of the SPF was that there should be no surprises caused by government announcements on NHS strategy and developments. The SPF, chaired by a minister, has developed its role and ensured that major initiatives in the health service including transforming community services and the new structures established by the 2012 Health and Social Act, and the staffing and organisational issues arising from these changes have been dealt with in partnership. The effectiveness of the SPF has been further enhanced by the work undertaken in sub groups such as the Workforce Issues Group (formerly known as the staff passport group) and the Francis sub group.

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There is a growing body of academic evidence which shows that good staff engagement, such as the partnership approach, can deliver better patient outcomes, as well as improve overall organisational performance (West et al 2011, West et al 2013 and The Point of Care Foundation 2014.)

The NHS Constitution emphasises the importance of staff engagement and partnership working and requires the NHS to commit to 'engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements.' The potentially serious impact of a disengaged workforce was highlighted in the Francis Inquiry Report (2013).

 National and regional, partnership working:

  • gives an opportunity for employers and trade unions to contribute their experiences and ideas on the development of policy that impacts on the health and social care workforce
  • gives partners the ability to assess the likely impact of emerging policy on the NHS workforce and to mitigate risk
  • enables more effective implementation of policy
  • supports high standards of employment practice.

A summary of what the national SPF has achieved and its priority work areas can be accessed here.

Locally, partnership working:

  • provides a transparent and streamlined structure for trade union, employer and staff engagement
  • supports an improved mutual understanding amongst management, trade unions and staff
  • has been shown to lead to better services for patients and users.

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The SPF brings together NHS Employers, NHS trade unions, NHS England, Health Education England and the Department of Health. Below is a statement from each of the partners on the national SPF and also one from regional SPFs, highlighting their own views on partnership working and what it means to them.

Department of Health
“The Department of Health recognises the positive contribution the SPF continues to bring to partnership working. As a growing body of evidence has emerged of the critical link between good staff engagement and patient experience, the need to engage with partners to help embed partnership working in the service and their contribution to the development and implementation of the workforce implications of policy is key.”

NHS Trade Unions
“Partnership working gives the NHS trade unions a real opportunity to influence the decisions that affect our members, who represent all NHS occupations. The basis of social partnership is our shared objective of delivering high quality health care services. This can only be achieved when NHS staff are properly trained, fairly rewarded and able to engage in the decision-making processes that affect them in the workplace.”

NHS Employers
“NHS Employers welcomes the opportunity to play a leading role in the national SPF. Through the SPF, we are able to hear about policy that impacts on the health workforce and influence its development and implementation so that it delivers maximum benefits for patients. Being a member of the SPF gives us an opportunity to build on our strong and constructive relationships with partners in the NHS Trade Unions, Department of Health, NHS England and Health Education England and work together to address issues and concerns. Partnership working also helps us to deliver products and services, that better meet the needs of the NHS.”

Health Education England
"HEE is committed to developing good formal and informal partnership working relations within HEE itself and with members of the wider national SPF. Being an active member of the SPF gives HEE the opportunity to work in partnership across the system with colleagues from the wider NHS and Trade Union organisations and allows for discussions on emerging issues in an open, honest and transparent way. This in turn contributes to ensuring HEE delivers its services and obligations effectively, and in partnership, supporting the delivery of high quality patient care and a supportive and developmental working environment for all of our staff."

NHS England
“The benefits of working in partnership with our union colleagues has assisted us greatly to understand where our staff are facing uncertainty, or require further clarification around organisation alignment and capability programmes. Through promoting openess, transparency and trust we have established a point of contact for our national union members, listening and acting upon information which greatly assists us in the development of policies and procedures. Our regional colleagues have also set up monthly meetings where specific issues can be raised, picking up problems early to avoid them becoming issues. Establishment of those relationships enables staff reps to get answers more quickly to queries, avoiding the need for escalation. Through staff side colleagues this is also an excellent route to communicate changes more effectively across the organisation.”

Regional Social Partnership Forums
“Regional partnership working has never been so important. We know that to deliver a world class health service we need a world class workforce. Regional SPFs have a role to ensure that the best in employment practice is adopted across each region. We also know that all 1.3 million NHS staff are going to feel the impact of the integration, reconfiguration and modernisation agendas essential for an NHS fit for the future. We bring together strategic partners to understand these policy developments and their regional impact. SPF members discuss and debate the potential implications and aim to influence and suggest solutions on those areas that affect the workforce.”

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Each year the SPF sponsors and judges the Healthcare People Management Association (HPMA) award for partnership working with trade unions, to identify, reward and promote excellent partnership working.

Included below, are links to the case studies from each partnership award winner in recent years:

2018 - Mersey Care NHS Foundation Trust won for their initiative implementation of a just and learning cultureThe award winning campaign saw trust and staff side colleagues working in partnership to improve the disciplinary process and create an open and honest culture where learning is shared. 

2017 - Norfolk and Norwich University Hospitals NHS Foundation Trust worked in partnership to develop A new attendance policy, a new approach to people management, a person-centred approach to managing sickness procedures. Listen to a podcast where the four finalists from 2017 talk about their winning projects and the challenges faced.  

2016 - Somerset Partnership NHS Foundation Trust for their exemplar See Something, Say Something campaign. 

2015 - Guys and St. Thomas NHS Foundation Trust for their exemplar management development programme ‘Passport to Management'. You can also listen to a podcast where the three finalists from this years awards, talk about their winning projects and the challenges they faced.

2014 - Business Services Organisation and Trade Unions, for their project which used a partnership approach to promote Lesbian, Gay, bisexual and transgender inclusive workplaces.

2013 - Developing an integrated Health and Social Care Partnership for West Dunbartonshire.

2012 – Bradford District Care Trust - Learning Disabilities Transition Programme.

2011 - 'Back to basics' partnership principles work for NHS Norfolk.

2010 – St George’s Healthcare NHS Trust - Building a respectful and passionate workplace.

This year, the SPF is continuing to sponsor the partnership award and more information regarding this can be accessed here.

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The SPF has developed a communications toolkit including promotional materials for partners to use to promote the work of the SPF, and the benefits of partnership working through their own communication channels.

The communications toolkit resources are available to download here:

Branded SPF Presentation

SPF Aims and Achievements

National and Regional SPF Factsheet

SPF Infographic

An SPF postcard is also available on request. The postcard can be used to promote partnership working and encourage partners to subscribe to the SPF bulletin. If you would like to order some please send an email to

The SPF has also recorded podcasts from members of partnership forums who have shared their experiences of partnership working. These can be listened to below.

Pam Johnson retiring Regional Head of health for UNISON at Yorkshire and Humber on partnership working

Dino Williams talks about the development of partnership working from a staff side perspective at Guys and St Thomas


Through their respective membership of European Federation of Public Service Unions (EPSU) and HOSPEEM, a number of the NHS trade unions and NHS employer organisations participate in European level social dialogue, via the NHS Confederation European Office. EPSU and HOSPEEM representatives work together to develop agreements that become legislation such as the sharps injuries in healthcare agreement, and non-binding agreements such as ethical recruitment and retention. They exchange good practice and agree joint responses to European Commission (EC) consultations, for example the Directive on the recognition of professional qualifications and are involved in EC initiatives and projects relevant to the healthcare workforce like CPD lifelong learning and workforce planning. 

Further information on the work and various projects of EU social partners can be found on the EPSU website and on the NHS Confederation website.