Large small case study - Addaction and Action for Change

Read a brief description of this case study

Drivers and early formation

The driver behind this partnership formation has been described as completely opportunistic'. But the primary driver was a local Drug Advisory Team's (DAT) commissioner's decision to consolidate and re-tender, in an open competitive commissioning process, all its existing contracts for substance misuse services to one single provider. The DAT felt there had been too many small local service providers whose collective costs were too high and there was also some dissatisfaction with some existing services.

This decision led to a rather frantic manoeuvring from all the existing drug and alcohol service providers, who began the process of searching for partners and looking for a good fit. Action for Change already knew of Addaction, there was a level of personal trust between the two main players so they approached them for discussions about a partnership bid. They each felt that with one of them having expertise in drug services and the other in alcohol, this was a good match, each had specific specialist expertise the other needed, so negotiations to jointly develop a service and tender for the contract began.

Neither organisation carried out any formal checks or due diligence processes, but each had copies of the other's annual accounts. Action for Change was clear that it couldn't expand its services without improving its infrastructure; it had an annual turnover of £180,000 and knew that to expand it needed a partnership with a large well resourced organisation. Addaction needed to make better local links and connections to develop its services; it needed a well-connected local organisation to do this.

The partnership bid won the competitive tender, but there was some fairly stiff local opposition to such a large service provider coming into the local area. An application for planning permission to develop a local building was blocked and meetings were picketed. The two organisations described this time as time to put your head down and just keep going'. They believed in what they were doing and wanted to keep focused, even in the face of local opposition.

Feelings were running high because as a result of the re-tender process several local service providers, including the NHS, lost a major income source. The success of this partnership resulted in a redrawing of the shape of the local substance misuse sector, which although painful at the time, has recently been described as a defining moment requiring everyone to regroup strategically. Some organisations have disappeared and some have gone on to develop other services. A voluntary sector forum has subsequently been set up to periodically review local services.

Discussions about who would do what and how the budget would divide up started early on, and developed over time.

I'm glad we didn't plan and chart out everything to the nth degree. That might have stopped us from developing a problem-solving approach. If we had planned too much it might have put us in the mindset of it's not working rather than how do we resolve this.'

The contract specified that the partnership should have no separation between the two organisations. There should only be one budget and one line of accountability to the commissioners. This led the two organisations to nominate Addaction as the accountable body and fund holder for the project. The main rationale for this was that Action for Change did not feel it had sufficient capacity to bear any financial risk. One thing they were both clear about was that the project management and supervision of the project manager was to be jointly responsibility.

Both organisations had to be pragmatic and give way on some things that were more important to them than others, such as who employed which staff and what the project was to be called. They felt they didn't really have time to debate all these issues, as they wanted to get on and deliver the project. They were also constrained in the early days by the timetable of the commissioning process.

It works because of senior management involvement and commitment to the whole process. It's been an emergent process, we didn't think it all through and then design the partnership agreement, and we had to be flexible to respond to issues as they arose, rather than plan everything.'

Operational issues

Management, staffing and governance

A joint management board consisting of the Action for Change CEO and the area manager of Addaction oversee the project. Addaction employs the operational project manager but both members of the partnership jointly supervise him. This level of integration, right from the start, is something identified by both organisations as a key success factor.

Project staff are employed by Addaction and by Action for Change. It has taken some time to get right but all staff are now on the same payscale. Terms and conditions vary across the two organisations, but are broadly similar (it should be noted that there are also NHS and local authority staff working in the project). Project staff view themselves as working for only one project. This process of merging identity and creating one project identity has been one of the biggest challenges the partnership faced, but also one of the biggest successes.

The staff now see themselves as part of a whole, not two parts. It works because the project has a separate identity and because the vision is inspired by pragmatic delivery of an excellent service for drug and alcohol users.'

Some of the Addaction staff have moved to work at Action for Change in Brighton and some of the local staff have gone to work for Addaction nationally. The two organisations believe that this way of working presents project staff with greater career progression and better workforce development opportunities.

The joint venture agreement covers issues of break-up and non-delivery but both organisations wouldn't expect that agreement to be the first port of call. Failure to deliver hasn't been an issue. However, the organisations have had to negotiate joint position statements to deal with some external pressures. If a new manager, with a different set of values, were appointed, this could potentially pose a risk but there are sufficient checks and balances against this in the recruitment procedures.

Financial arrangements

The project has only one budget. The contract grant goes to Addaction and all bills and invoices are put through its accounts. Action for Change invoices Addaction on a quarterly basis for its costs. Decisions about the budget were initially made on a very simple pragmatic basis of each organisation charging for the percentage of contribution it would make to provide a service. Both organisations take a management charge but this is currently under pressure from the commissioners who are renegotiating the whole contract budget.

At the heart of these financial decisions is the percentage of risk both organisations were and are able to carry. Initially, Action for Change was not able to carry the financial risk of a deficit budget. But with its turnover growing to some £3 million, it is now more able to carry equal risk. This is now being reflected in a newly negotiated agreement. It's still not 50:50, but the organisations have an interesting view on equality and diversity that is not just relevant to finance, but to their approach to large small partnership as a whole.

As a small organisation you can't pretend you are equal to the large. You develop equality but equality is not only 50:50, it's also about the common respect and dignity against the strengths and weaknesses of both organisations. Addaction was, and remains a bigger organisation than Action for Change. You have to consider your core position, we might not have got the contract without them, they might not have got the contract without us - I think the right balance has always been there.'

Technical/operational issues

There has been a lot of shared technical assistance and capacity building in this partnership. Addaction has rolled out its core competency training to Action for Change staff, which they would have found difficult to access alone.

As a large organisation, with a dedicated HR team, Addaction has also been able to help with employment issues. Action for Change, as a small flatter organisation, is sometimes more able to be fleet of foot' or to get access to practical learning and feed this through the organisations much more quickly.

The partnership has been able to use the Addaction Public Relations team to manage the communication process of moving to new premises and to access the services of an Addaction chartered surveyor. Information, Communication Technology (ICT) support and financial systems support have been offered and taken up by Action for Change, as have systems for internal audit and performance review.

Both organisations have exchanged expertise and built each other's capacity in relation to the provision of drug and alcohol services. Addaction's capacity to deliver other joint substance misuse services in other parts of the country has been greatly assisted by its partnership with Action for Change.

Both projects are clear about the local benefits they get from working in partnership. Action for Change has a sophisticated network of contacts in the city. It gets invited to and involved in lots of local events and forums and is able to feed these into the project.

We are the local face, we get involved in other agendas that substance misuse is part of, we can access wider opportunities like community safety forums. Addaction, alone, would miss out on these. We don't underestimate this, having those local contacts is very helpful. We bring in the technical support, Action for Change bring the local connections.'

The project's services are monitored and evaluated against targets. However the partnership itself has never been evaluated. Quantifying how the partnership has added value to the provision of the service may be of future assistance in demonstrating value to the commissioners who may begin to query the relevance of two separate sets of management costs. Cost benefit savings may be made in some areas but are, by and large, offset by additional expenses in others.

I'd be surprised if users knew this was a partnership, we wouldn't want them to, and the real question is, are users getting the best service possible? Full stop.'

Cultural issues

Understanding and working with two different organisational cultures has been the most challenging area of work for the partnership. This is where size really matters. Addaction as a national, corporate organisation with local services all over the country, sometimes has to make one size fits all' decisions. Action for Change, with its flat hierarchy and local hands on feel, likes to operate quickly and flexibly; inevitably this brings about tensions. The crucial factor here seems to be the active involvement of senior managers from the national organisation. In particular, what seems to have worked well in overcoming cultural tensions was the initial decision to integrate the whole service under one jointly supervised manager.

It was key to have one manager, who was jointly supervised. This allowed the whole thing to be one unit. If we had each appointed a manager it would have been a disaster. It's the one thing that allowed the partnership to flourish, joint supervision and one manager.'

Action for Change feels that it has managed cultural tensions by being pragmatic and choosing the important battles to fight. Managing culture seems to have been as much a challenge for Addaction, which needs to have an acute awareness of the differences between its own local branch projects and this partnership. There are huge expectations placed on the area manager of the large organisation who has to manage upwards on behalf of the partnership and downwards on behalf of the national organisation. He can feel a bit trapped in the middle, with a foot in both camps'.

Future resources

Both organisations would have liked to have spent much more time on the development phase of the partnership. Access to a partnership development grant or access to some consultancy time or a helpline to talk over issues of concern with a partnership expert' would have been very useful. More so than standard models and contracts, which could be dangerous, as they could substitute the real process of negotiation that's needed to draw up any partnership agreement.' However, checklists of what to put in agreements and access to legal advice would be of use.

It would also be useful to hear about other organisations' experiences of large small partnerships, maybe some sort of buddy scheme or visiting scheme or even a speed dating scheme, where you could meet other partners looking for new partners.

The final point concerns the need for realism and unease about the current trend to talk about partnership generally, as if it's the ideal and only way of delivering services:

No two people spend all their time in paradise, any partnership has its ups and downs, strengths and weaknesses. You have to pace yourself and look at the long picture - if you expect it to be quick or easy you will be very disappointed.'

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