Exploiting informal opportunities

Exploiting informal opportunities to provide clarification of HIA project activities was achieved by utilizing all moments for engagement which served to maintain effective relationships. An example of how this activity worked in practice was illustrated by the following corporate executive:

[My MM] plays an absolutely key role in terms of management particularly as we have moved to a much slimmer management structure…I’m sure [my MM] would have been in touch if there were any major issues with that and certainly when I have talked it through with [my MM] things are going pretty well (CE2).

The following section considers how MMs have exploited informal opportunities to sell issues related to the HIA project.

Providing clarification

MMs ensured that the HIA project continued to be supported by corporate executives through exploiting regular briefings, which provided them with the opportunity to provide clarification on the HIA project activities:

I think for me now it is having the support of [my corporate executive] giving that support as well. So I think what has been difficult for me personally is that I have had a number of changes in my [corporate executive] over a period of time. And so

sometimes it feels like going back to the start to influence and negotiate and to get that commitment but then once I’ve got it this

This example highlights the commitment that the MM put into developing a solid relationship with a corporate executive. This was driven by the fact that once this association had been forged it was a very effective way to provide clarification on HIA project activities. It was achieved by taking advantage of situations that enabled the MM to synthesise information for corporate executives as part of their issue-selling strategy. The ability to capitalise on informal opportunities for raising awareness with corporate executives was, therefore, integral to the ability for MMs to maintain their backing. This example also demonstrates the dedication that MMs put into the development of solid relationships with corporate executives as a means of enabling them to continue with activities that had been developed within their professional service area.

Field note 67: 06/06/13 observed MMs engaged in proactive efforts by discussing attempts to push issues in front of corporate and political executives. This is defined as a process requiring proactive persuasion to gain acceptance on the concepts of partnership working and integrated service delivery.

Utilizing opportune moments

MMs ensured that they took advantage of opportune moments to sustain the support of corporate and political executives. This was a purposeful activity that preserved their support and it was driven by the recognition that this was a key activity that required constant attention:

I just have to keep pushing that. I think I can influence by the behind-the-scenes by getting people on board. I think[corporate and political executives from two local authorities] are now beginning to get a close working relationship around this type of work. There is a common interest in our pilot and I can see that there are some allies there. In terms of the way we are thinking. So strategically that is my play I just keep the pressure on and gather

allies so that we can deliver the service (MM6b).

This example provides an insight into the intricacies enacted by the MM in order to secure and maintain buy-in to the HIA project. The activity was motivated by an awareness that the HIA project activities would be bolstered by the backing of as many corporate and political executives as possible. It would enable the MM to promote the achievements that had been accomplished by activities within the HIA project in order to sustain the endorsement of corporate and political executives.

Field note 123: 28/03/14 provides confirmation of close working relationships between MMs and political executives. MMs were conscious of the fact that current provisions for delivering the HIA project would only remain viable if they could provide convincing arguments that outsourcing would be more costly option. This required MMs to find opportune moments with political executives to demonstrate financial effectiveness through examples that could demonstrate value for money.

MMs demonstrated resolve in ensuring that they maintained their relationships with corporate executives as a means of utilizing opportune moments to discuss issues relating to the HIA project. This was achieved through brief informal meetings that

were convened to check how adequately the activities of the HIA project were contributing to corporate strategic objectives:

I meet my corporate executive on a monthly basis soon after the meeting. It gives [my corporate executive] the opportunity to challenge from outside as well as to understand where we are. What I try and do is provide a good oversight of things like any project problems, and talk about cultural issues. Occasionally what I will try to do…in broad terms if there is a particular problem that needs unblocking or something like that I will talk to one of our [corporate executives] and see if they can raise that at countywide meetings …. So we have got the methods in place there

are mechanisms there (MM1b).

This example demonstrates how the MM used the opportunity to provide a de-brief of HIA project board meetings via a meeting with a corporate executive to provide clarification on current activities. This activity was driven by a desire by the MM to preserve the interest of the corporate executives and this was achieved by raising awareness of specific aspects taking place within the project and possibly asking for assistance on specific issues.

While MMs were enthusiastic in their desire to make good use of occasions where they could engage with corporate and political executives informally, it was evident these opportunities were also useful in solving issues requiring intervention at a higher corporate level:

We are all at a significantly high level in our own organization to make decisions and to make things happen we do not really need the top tier executives to make that happen for us. So a lot of the

time it is making sure that we interact with them as needs be. I mean if I can conceive of the situation where we might get involved at the highest level through the district and county mechanisms with the chief executives would be if somebody was deciding to drop out. But we have managed to keep the HIA coalition

together, partnership is probably a better word, through our own

efforts so it is not generally needed (MM1b).

This highlights that MMs were committed to developing relationships with corporate executives on the basis that they were a resource to be drawn upon circumstances where an intervention at the top-level was required such as if a local authority was contemplating leaving the partnership. In these circumstances the MM would exploit the relationship that they had developed with their corporate executive to gain agreement to discuss the possible departure with the corporate executive of the local authority in question on behalf of the MM.

Maintaining effective relationships

In order for MMs to preserve a positive association with their political executives it was essential that this relationship was very carefully managed:

A lot of this work comes down to trust I have said this before it comes down to relationships. If we all feel that we have been turned over in some way we’re not going to do it again are we? Or at least our members will tell us that we are not doing it again. It is

very important how we deal with this (MM1b).

This provides an illustration of the resolution of the MM to build up a dedicated alliance with their political executives, including influential elected members with

responsibility for the service-area. This established relationship could then be utilised to support their arguments. It included matters such as discussing the fair allocation of funding in committee meetings that included external health agencies. This was necessary because the political executives had the power and influence to support the MM in key discussions such as these. As these conversations often affected the future direction of the HIA project, the MM played a pivotal role in ensuring that this relationship was managed effectively.

Field note 210: 27/03/ 15 observed MMs discussing how to explain a strategic outline case for delivering home adaptations to political executives. This activity demonstrates the proactive interactions of MMs in building upon the relationship of trust that had been built up with political executives.