Collaboration in Action – Working Together on Health Governance

We talk about collaboration a lot on this blog, and that’s because it important to make sure our partners work adds value to public services. It would be a waste of resources if we all looked at the same things in the same way. It’s important for other reasons too, if we looked at services through the same lens we might miss important issues.

Talking about it is one thing, but we thought it would be nice to show you how collaboration actually works for health services in Wales. Two of our partners both have roles in the external review of health service governance. Now you might think governance is somewhat dry subject for a blog, I would beg to differ!

Governance in it true sense is an enabler for effective organisations, it determines the big, important questions, like how do we do things around here? Is it acceptable to do this? How is an organisation structured? How do the leaders know if we are doing the right things? In health- are our patients safe?


Healthcare Inspectorate Wales and the Auditor General for Wales both have specific remits which include governance of health services in Wales. Our partners could both just go out and review governance independently of each other, and report through their channels. But they decided that working collaboratively was better [opens in new window]. The paper [opens in new window]accompanying this blog explains how they do this in a clear way, but my summary is that we made a strategic decision to come at governance from two directions.

HIW approaches it from frontline services in individual wards and service areas, whereas WAO approaches it from the organisational top-down perspective. This means that our work complements each other. That is not enough on its own to get maximum value from our work, so we also work collaboratively in many ways, we use various formal and informal liaison mechanisms to make sure we make connections from what our work is telling us, and are able to spot many problems and draw attention to them before something awful happens.

We do this through our Healthcare Summit process, regular meetings between senior and operational staff from both partners, and engagement with Welsh Government through the NHS Escalation and Intervention process [opens in new window].

So what?

We have evolved our collaborative working since devolution, this is not something new, and this has helped us to produce a number of joint pieces of work from CAMS, to the Betsi Joint review of governance in 2013.

This is a good example of collaboration in action, and I hope you will read our partners paper.