Case Study

Partnership working across health and care

Find out how Greater Manchester established partnership working arrangements to address workforce issues impacting the city's health and care systems.

27 October 2022


Greater Manchester (GM) established partnership working arrangements six years ago to address workforce issues which impact the city's health and social care system. These arrangements included setting up a Greater Manchester health and care workforce engagement forum, which brings together trade unions, employers and parties working across the whole health and care sector.

Better partnership working has most recently helped in their approach to supporting staff through the Integrated Care System (ICS) transition to NHS Greater Manchester Integrated Care.

Some of the challenges include:

  • managing NHS provider business at a system level without disengaging other parties
  • establishing trade union recognition across primary and social care where there is a lack of formal trade union recognition or access
  • working across the sector when a lot of it is not unionised.


When GM developed its first health and care workforce strategy in 2017, partnership working was an underlying principle and the decision was made at that point, during the formation of the People Board (previously known as the Strategic Workforce Board), that trade union representation would be essential to the work. This led to the establishment of the GM Health and Care Workforce Engagement Forum, which is complemented by the Workforce Engagement Board, chaired by the elected mayor of Greater Manchester, Andy Burnham. Membership of the Workforce Engagement Forum includes trade union and employer representatives from local authorities, primary care and the NHS.

Action taken

Partnership arrangements with trade unions in GM are as follows:

  • Workforce Engagement Forum – system engagement across primary, secondary and social care.
  • NHS GM Partnership forum – established in 2021 to address the transition to an ICS and establishment of an Integrated Care Board (ICB).
  • Creating links to local partnership arrangements in individual health and care organisations.
  • Workforce Engagement Board – comprising health and social care leaders, voluntary, community and social enterprise sector, trade unions and chaired by the city region’s elected mayor. 

The role of partnership working

Partnership working between employers and trade unions has helped:

  • develop trusted relationships
  • provide insight into the formative stages of system wide programmes, with an opportunity for co-design
  • identify early on developments which transcend traditional health and care sector boundaries (such as blended roles in social care), or that impact multiple health and care employers (such as the GM Pharmacy Supply Chain Hub), presenting an opportunity to work through potential hurdles and establish an inclusive and efficient approach to the consultation
  • agree on consistent approaches to consultation on key workforce developments, ensuring that local trade union colleagues are engaged, and meaningful discussions take place between unions and employers in each of the city region’s localities about system-level developments. An example of this was the blended roles gateway framework, which set out the need to consult locally on the implications of this new way of working.

Results and benefits

Through partnership working the results and benefits include:

  • GM continuous service commitment
  • consultation gateway frameworks for improving specialist care and blended roles
  • vaccination as a Condition of Deployment plans, albeit this was later withdrawn by the Department of Health and Social Care
  • GM Pharmacy supply chain – the first use of GM Good Employment Charter in NHS commissioning
  • establishing ICB partnership arrangements were easier because the relationships and structures were already in place.

Sharing learning

  • Keep a commitment from all parties is essential for the development of trusted relationships.
  • Keep the agenda at a system level rather than being pulled into organisational issues.
  • Speed of engagement is key so that opportunities are taken at the early stage of developments to influence and shape policy.


"Our approach to partnership working in Greater Manchester has enabled us to build strong relationships with trade union colleagues and address system wide issues together. We still have challenges and intend to continue working together to achieve the best outcomes for our workforce and communities"

Janet Wilkinson, Executive Lead – Chief People Officer, NHS Greater Manchester

"Having a structure through which managers, HR professionals and staff’s trade union representatives are around the table together at a system level has meant that we can have early, comprehensive discussions about developments which impact our members across organisational and professional boundaries. Where this works well it not only helps identify potential solutions to our members’ concerns at a system level, but also improves industrial relations and engagement in individual employers by ensuring key issues and developments are discussed with those impacted, at a formative stage"

James Bull, GM Partnership Staff Side Health Lead, Unison North West


Further Information

For further information please contact Janet Wilkinson, Executive Lead – Chief People Officer, NHS Greater Manchester or James Bull, Regional Organiser and GM Health Lead, UNISON North West