Promoting partnership working in the NHS

About SPF

The national Social Partnership Forum (SPF) brings together NHS Employers, NHS Trade Unions, NHS England, Health Education England (HEE), NHS Improvement and the Department of Health to discuss and debate the development and implementation of the workforce implications of policy.

The primary aims of the national SPF are to:

  • contribute staff side and employer perspectives to emerging policy at a formative stage
  • improve policy development and implementation by feeding in ideas on workforce implications
  • promote good practice in relation to partnership working and effective communication between partners.

Another key aim of the SPF is to encourage employers and trade unions to work together to ensure a positive working environment, in which staff can provide high quality care and services. To facilitate this approach, the national SPF signposts useful tools and resources to promote and support partnership working in the NHS on the How we do partnership web page. Case studies are also developed by partners and published on the SPF website, to evidence positive outcomes achieved through partnership working and to share learning. Employers and trade unions working together also helps to ensure staff are actively engaged, supported and consulted in issues impacting on their workplace/organisation. There is a growing body of evidence to demonstrate that effective staff engagement is essential in creating a positive culture of safe, compassionate care and is strongly linked to improving patient outcomes and organisational performance. 

SPF does not discuss the contractual arrangements for NHS staff as this is carried out in the NHS Staff Council which has overall responsibility for the Agenda for Change pay system.


SPF partnership agreement

An updated partnership agreement was published in July 2016 to reflect the healthcare system established as a result of Health and Social Care Act 2012. This agreement formally brought NHS England, Health Education England and NHS Improvement into the SPF alongside the historic partners - the Department of Health, NHS Employers and NHS Trade Unions. 

The updated partnership agreement sets out the framework through which the partners commit to work collectively to tackle the healthcare priorities and challenges. 

The agreement was signed by Ben Gummer, the then SPF Ministerial chair, Simon Stevens, Ian Cumming, Jim Mackey, Charlie Massey, Danny Mortimer, NHS Employers SPF chair, and the then NHS Staff Side chair Christina McAnea (UNISON), with a foreword by the Secretary of State for Health. 

SPF members’ Handbook

The Handbook was drafted for new members of the national SPF to explain the purpose of the SPF, the role of partners and how a member of the forum, can get involved to support it achieve its aims. The Handbook also provides practical information on the SPF's detailed working arrangements and the membership of the SPF Strategic Group and Wider Group.


SPF sponsored HPMA award for partnership working
SPF actively encourages partnership activity through the sponsorship of the Healthcare People Management Association (HPMA) award for partnership working with trade unions, to identify, reward and promote excellent partnership working.

Partnership working – good practice
SPF continues to promote partnership working by gathering examples of good practice. Case studies are published on the SPF website evidencing the positive outcomes achieved locally through partnership working where employers and trade unions work together to agree joint solutions to issues affecting the workforce. This process helps to ensure that staff are actively engaged, supported and consulted in the workplace.

SPF Stocktakes

Building on Partnership - SPF Stocktake 2015, was an independant review of the National SPF's effectiveness since new ways of working were put into place in April 2013.

The national SPF has been particularly keen to support the continued development of regional SPFs. The 2013 and 2014 annual SPF stocktakes focused on supporting regional SPFs following transition and to nurture greater linkages between the national SPF agenda and those of the regions. 

As a direct result of these stocktakes, regional SPF representatives now attend national SPF meetings on a rotational basis, and  members of the national SPF attend regional SPF meetings.  This  has helped to foster better two-way communications and connectivity.

Redeployment of staff
Regional SPFs have published a Memorandum of Understanding (MOU) on redeployment of staff, which sets out the principles across the  four regions whereby NHS employers can sign up to wider redeployment of staff who are at risk of redundancy.



In a communication to regional SPFs, sent November 2017, the national SPF set out the priority areas it will focus on until April 2019. The key areas come under three broad headings:

NHS culture and staff experience

  • Promoting positive cultures and tackling bullying in the NHS: a collective call to action.
  • Developing people, improving care. The SPF is engaging with NHS Improvement on its national strategic framework for action on improvement and leadership.

Service transformation

  • NHS Forward View – sustainability and transformation plans/partnerships (STPs) and accountable care systems (ACSs). This includes work to de-risk system change and to remove potential obstacles to staff working across organisations.
  • Partnership working - work to support staff and trade union engagement in system change.

Service delivery

  • Operational productivity and efficiency.
  • Staff retention and supply, linked to workforce system and planning.
  • Agency spend reduction programme.
  • Safer staffing improvement. 

Leadership and workforce culture is a golden thread, which links all the priority areas and international workforce issues will be a cross-cutting theme.


An independent review of the SPF carried out by the IPA in 2015 made a recommendation for the SPF to highlight where it has made a difference. In line with this recommendation, the SPF produced a key achievements document which sets out where the forum made a difference - September 2016 to September 2017. SPF achievements from July 2015 to August 2016 are set out in a portfolio of evidence of impact available as a related document on the Embedding Partnership Working Group web page.      

The work the national SPF is undertaking under its priority areas is recorded in the national action log, which is updated approximately every three months.


Membership of the national SPF includes representatives from the following organisations:

Department of Health, NHS England, Health Education England, NHS Improvement, NHS Employers (and representatives from individual employing organisations) NHS Trade Unions (including British Orthoptic Society, British Association of Occupational Therapists, British Dietetic Association, British Medical Association, Chartered Society of Physiotherapy, Federation of Clinical Scientists,GMB, Hospital Consultants and Specialists Association, Managers in Partnership, Royal College of Midwives, Royal College of Nursing, Society of Chiropodists & Podiatrists, Society of Radiographers, Trade Union Congress, UNISON, Unite the Union)

The SPF Wider Group meets three times a year. It is chaired by Philip Dunne MP, Minister of State for Health. 

Conduct of meetings 

Items may be placed on the agenda by any of the parties. Secretariat arrangements are led by the Department of Health, who liaise with key contacts from NHS Trade Unions, NHS Employers, HEE, NHS Improvement and NHS England. All partners are encouraged to use the forum to showcase effective partnership working in line with the aims of the forum. 

The SPF chairs manage business and maintain proper conduct of meetings and are responsible for ensuring that individual members uphold the partnership principles and the co-operative spirit of the forum. 

To help facilitate effective working the partners agree to the following:

  • every effort will be made to provide information in good time for discussion and/or consultation
  • all parties will undertake to provide a considered, co-ordinated and timely response to issues on which their views are sought/on which they are consulted
  • all parties to respect confidentiality where that is required or requested; and otherwise to conduct their dialogue openly. 


Key communications from the wider group meetings are agreed by all partners and published on the SPF website.

For more information 

See the SPF Wider Group’s terms of reference


The Strategic Group is co-chaired by NHS Employers and NHS staff side. The group, which meets five times a year, is a streamlined forum in which robust Chatman House debates can take place between partners on policy with workforce implications. The Strategic Group is supported by the SPF secretariat and the group provides regular updates to the SPF Wider Group meetings – through a standing item on the agenda. 

For more information see the SPF Strategic Group’s terms of reference

The SPF has a dialogue with the Care Quality Commission (CQC), to enable social partners to inform and support the work of the CQC where it impacts on the workforce. 

Read the agreed meeting arrangements which are in place to facilitate engagement between the SPF and CQC. 

Action notes from previous meetings between the SPF and CQC are listed below.

September 2016

February 2016

April 2015

SPF Strategic Group

Update on 7 day services - SPF Strategic Group - June 2014.

NHS England finance update - SPF Strategic Group - June 2014.

CSU update - SPF Strategic Group - June 2014.

VBR update - SPF Strategic Group - September 2014.

Update on 7 day services - SPF Strategic Group - December 2014.

The future NHS - NHS England - SPF Strategic Group - February 2015.

Update on 7 day services - SPF Strategic Group - June 2015.

Brexit presentation, Kate Ling, NHS European Office - SPF Strategic Group - September 2016.

SPF Wider Group

Employee Engagement and Patient Outcomes - Michael Wests presentation to SPF Wider Group - March 2014.

Time to Change - Presentation from Sue Baker at Wider SPF - March 2014.

Workforce Race Equality Standard (WRES) - Presentation from Roger Kline and Yvonne Coghill - July 2016.

SPF proposals to tackle Bullying and Harassment in the NHS - Update paper - July 2016.

NHS Apprenticeships - Alan Robson, Department of Health - October 2016.

National Guardian update - Dr. Henrietta Hughes, National Guuardians Office - October 2016.

New Care Models update - Clare Simpson, NHS England - October 2016.

2016 NHS Staff Survey Results - Clare Enston, NHS England - March 2017.

Flu fighter campaign update paper - March 2017.

Freedom to speak up/Freedom to improve - West Suffolk NHS Foundation Trust - March 2017.

SPF Stocktakes

2015 SPF annual stocktake report

2014 SPF annual stocktake report

2013 SPF annual stocktake report

NHS England

The NHS Belongs to people - A call to action

The Forward View into Action - Planning for 2015/16

The NHS Five Year Forward View: New Models of Care Programme