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Building buy-in, enhancing decision making and staying accountable

The most common question I hear from folks who are in the thick of trying to maintain an effective health justice partnership has got to be, ‘how do I get my partners to maintain their buy-in to what we’re doing together?’. My answer (or, rather, my question in response) is consistently the same: to what extent have your partners been involved in the design of, and decision making around your partnership? In other words, how much collaborative governance does your partnership benefit from?  

Because building effective decision making and accountability mechanisms around your HJP is much easier said than done, I’m going to spend the coming months working on some practical tools and resources to support the national health justice landscape strengthen its collaborative governance muscle. To kick that work off I’ve pooled together some of the biggest (and hardest) lessons I’ve learnt in supporting this work over the past few years. But before I get stuck in, let’s make sure we’re on the same page when talking about the concept of collaborative governance… 

‘Big G’ vs ‘little g’ governance in HJP  

For the most part, we’re not talking about ‘Big G’ governance. That is, we’re not talking about organisational systems of compliance and risk management. We’re not talking about the legislative frameworks with which organisations like those across the health justice landscape are required to operate. Mostly, we’re not talking about the role of the boards that govern your organisations. The exception to this is when working within an Aboriginal Community Controlled context, where building an equitable approach means it’s vital that the authority and agency of the boards of those organisations is respected. HJPs should factor this into their timeframes and planning when looking to partner with Aboriginal Community Controlled Organisations. This will mean taking meaningful steps to account for the colonialist legacy within which the partnership is being built, investing in processes that are equity-centred and anti-racist, and being prepared to wait for an invitation to have a seat at that partnership’s table. This is as much the work of Health Justice Australia as it is the services we support.  

In this blog we’re talking about the processes, structures and relationships that support effective decision making and accountability when working in an HJP. We’re talking ‘little g’ governance. There’s lots we’ve come to know in the past 4 years and there’s lots more to learn. Here are my top 4 takeaways from our work to date in supporting effective collaborative governance in HJP. 

1. It’s hard to achieve a genuinely shared approach without first understanding and rebalancing power 

It’s a tough one, I know. But if we’re to make gains in the building of genuinely equitable partnerships that are underpinned by strong collaborative governance, we’ve got to start getting comfortable talking about and disrupting power – in our own selves as much as the dynamics of our partnerships. That’s why I recently blogged about using a power audit in HJPs. A power audit is a tool you can use to identify the different forms of power that exist within yourself and your partnership, and where power could be better drawn upon and shared to build a partnership that is equitable and accountable.  

2. Form really does follow function   

There’s no one-size-fits-all approach to collaborative governance in HJP. Like all other aspects of forming and maintaining effective partnership, your collaborative governance approach will be driven by your HJP’s own unique context and needs.  

Understanding what you’re trying to achieve in your partnership will be a necessary precursor to building a fit-for-purpose collaborative governance structure. Our work with HJPs has taught us it is much easier to build processes, relationships, and systems of accountability when HJPs have already started investing in a shared goal and vision. For the services we’ve supported this has meant considering the difference between implementation and strategy. That is, identifying what you’ll need to support the day-to-day implementation of the HJP; what you’ll need to make gains in integrated policy, strategy, and funding solutions; and what personnel and resourcing will be required to be effective at and accountable to both areas of the HJP’s business.  

3. Make room for diverse perspectives and interests 

Collaborative governance requires a readiness to create space for the interests of others, which sometimes means putting our own interests aside, not away altogether, while we seek to understand those of others. It is by carving out this space that you can start to find what is shared, and, as importantly, what isn’t. You can do the important work of unearthing and reality-checking expectations of participation and contribution, test assumptions, seek clarity, and ask for what you need. There may be things you agree to disagree on. And it is in these conversations that you may even decide that now, for whatever reason, is not the time to partner.  

 In our Building blocks for HJP development resource we share some tips and recommendations for having these formative, ‘what’s in it for me and what’s in it for us’ conversations. The section around identifying needs and service gaps, and agreeing on how you’ll work with others, are particularly important here.  

4. With investment comes reward 

The value of fit-for-purpose collaborative governance can’t be underestimated, especially when the approach is equity-centred and actively draws on the diverse perspectives, resources, and contributions of all partners. Just some of the value-adds we’re seeing because of shared decision making and accountability in HJPs include: 

  • securing a shared sense of accountability, both in terms of implementation and of vision and strategy; 
  • deepening engagement and participation with and from the teams needed to achieve the goals of the partnership; 
  • investing in more shared activity and processes, including identifying and prioritising what’s needed to induct and orient new people to the partnership;  
  • the development of agreed and appropriate communication pathways;  
  • clarity of expectations, approach and shared goals (and the ways in which those goals are being worked towards); 
  • mapping service access trends, their implications for the HJP and co-creating of strategies in response; and  
  • identifying and responding to staff capacity and capability.  

What do you see as the opportunity and challenge of good collaborative governance in HJP? Share your thoughts with us and help contribute to the design of HJP-ready collaborative governance tools, resources and support. Email us at partnerships@healthjustice.org.au.

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A guide to developing and implementing a health justice partnership that responds to local conditions and needs.

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