Promoting partnership working in the NHS

We, not them and us - Birmingham and Solihull Mental Health NHS Foundation Trust

The organisation

Birmingham and Solihull Mental Health NHS Foundation Trust provides mental health care to people living in Birmingham and Solihull. Operating from over fifty sites the organisation is one of the largest mental health facilities in the country with over 4000 staff who are dedicated to helping people and challenging the stigma associated with mental illness. 

The challenge

In early 2016 a historical culture of mistrust between trade unions and management and a lack of meaningful engagement was resulting in strained relationships, lengthy challenges to process and a lack of progress being made on much needed workforce initiatives. These issues were detrimental for staff and service users.

The aim

The aim of the We, not them and us project was to redesign and refocus, in partnership, meetings between trade unions and the HR team. Previously, business as usual meetings were the primary vehicle for interaction between trade union and HR colleagues, however the meetings were utilised in an ad hoc manner with few constructive outputs. It became clear that allowing the meetings to be dominated by low level discussions about disagreements in relation to individual cases, was compromising the important task of representing and supporting employee voices in the organisation.

The process

There was clear agreement that the current way of working was not in the best interest of staff or in the true spirit of partnership working. A collective decision was made to establish a sub-committee of the trust’s joint negotiating and consultative committee, the joint operational subcommittee (JOSC). Partners agreed that all policies, corporate work programmes, national regulatory requirements and organisational change programmes impacting staff would be developed and consulted on with the support of the JOSC, prior to being ratified by the executive team

In addition, members of the JOSC:

  • established and agreed principles for working together in partnership including sharing relevant information at the earliest opportunity and respecting confidentiality
  • identified information the committee needed to access regularly to address risks
  • conducted a wider stakeholder analysis
  • agreed a communications strategy and new ways of working to embed the new social partnership approach into the fabric of the organisation.


The success of the project has resulted in sustainable, effective and constructive partnership working between trade unions, HR and the wider organisation, resulting in a programme of improvements and benefits for staff and consequently, service users.

Key achievements include

  • An innovative multi-union learning agreement, using the union learning fund to train and develop staff in bands 1-4. Training includes functional skills such as english and maths, developing interview skills and CV writing. A management training programme has also been implemented for all new and existing managers in the trust.
  • The development of new policies that have been actively led in partnership by HR and trade unions eg a trans inclusion policy and an organisational change policy.
  • A refocus of the sickness absence policy through the introduction of a new disability leave procedure. The new procedure supports staff to remain well at work for as long as possible by giving a set allocation of days to be taken in circumstances where the staff member has an underlying health condition covered by the Equality Act. This has led to a reduction in the number of final sickness reviews taking place.
  • The implementation of a reasonable adjustment passport for staff with underlying health conditions.
  • A refocused bullying and harassment policy to encourage staff to challenge negative behaviour resulting in a 70 per cent increase in the reporting rate.
  • The succesful implementation of a trade union supported blanket policy for security checks on patients to ensure staff are kept safe.

Top tips

  • Trust in partnership working, it really makes a positive difference.
  • Open dialogue at the earliest opportunity about longer term planned changes and organisational risk management requirements.
  • Working in partnership to develop plans and strategies is more likely to be met with success, due to higher levels of engagement and contextual knowledge.
  • Focus on achieving collective outcomes through a values based approach, to determine working principles which become the cornerstone of commitments and practices.

Further information and contact