Little Miracles
This report summarises learning from a development programme establishing six communities of practice in England. The aim was to improve front line collaborative responses to people facing multiple needs and exclusions. It shows a relatively small financial investment leading to considerable gains. ‘Communities of practice’ are a way of brokering knowledge and social relationships between different groups of practitioners, creating potential for interdisciplinary learning and more collaborative ways of working. They have been used in a wide range of independent and public sector settings and are closely related to ‘managed clinical networks’ in the NHS.
This development programme was set up to take forward promising findings from recent research. The focus of this follow-on project was on broader multiple needs and exclusions, such as drug and alcohol dependencies, mental health problems and the criminal justice system.
This development programme shows that communities of practice can achieve considerable gains. These include building collaborative relationships, opening opportunities for interdisciplinary education and learning, and improving certain kinds of outcomes, particularly by sustaining the workforce. This provides an important reality check about what is possible through integration.
Four key points emerge from the learning:
- Managers and commissioners need to nurture front line collaborative practice.
- The amount of brokerage and development that may be needed to set up a community of practice in areas with a history of poor joint working should not be underestimated.
- Realism is needed about the outcomes that collaborative and integrative practice can achieve. Maintenance and prevention linked to resilient and continuous practice over the longer term should be valued just as much as recovery.
- Commissioners and managers should show support and actively seek to gain valuable intelligence about the complex realities of frontline practice.
