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David Relph: what the future holds for the partnership

17 December 2014

Bristol Health Partners Director David Relph reflects on his first nine months in the role, and looks ahead to what 2015 and beyond holds, outlining his ambitions for the partnership. This is part of a new series of blogs, where key players in Bristol's health sector write about a health related subject of their choice. If you want to contribute, email

I have been the Director of the partnership for just over nine months now, and this period has been among the most enjoyable and interesting of my working life. I've had the chance to work with a range of exceptional people on things that will really make a difference to our city and region and the people who live here - and the time has been stimulating and rewarding as a result.

I said early on that my aim in the role was to develop and initiate an ambitious yet realistic framework for Bristol Health Partners for the next five years, with a clear plan for the next two years. I presented my proposed plans to the Board this month, and, after incorporating their feedback into my plans, I will be able to share it more widely in the New Year.

In the meantime, I wanted to share a flavour of some of the discussions I've had with a whole range of people about the partnership and where we go next.

As I said in April, there is a huge amount to celebrate in the work of Bristol Health Partners so far. The partnership - and the way the different organisations have collaborated - tells a very positive story about our city and region.

There is much to build on and the partnership is now well established, but we need a clear view of what the future looks like for the partnership. Decisions that we make now will shape this directly, and I want to be clear at the outset that I favour ambition and boldness. In many ways the role and impact of the partnership is limited to whatever we collectively decide to use it for.

If we are ambitious, the partnership can become one of the means by which we work together for the benefit of our region and the people who live here. I am very strongly motivated by the contribution that the partnership can make in this regard and the plan which I referred to above will describe what this looks like in practice.

There is a future for our health and care system waiting to be created; the partnership has to be part of that story. Clearly, this is an agenda that will overlap with the work of others. Bristol Health Partners doesn't need to do the work of others, and there are a number of balances to be struck: between the work of the partnership and the work of other organisations or groups, and between supporting, convening and leading. The plan I have been developing will, I hope, describe how we do that.

What could we achieve?

Let's look at the mission of Bristol Health Partners (which I've adjusted in a small way):

Our mission is to generate significant health gain and improvements in service delivery in and around Bristol by integrating, promoting and developing local strengths in health services, research, innovation and education.

This is a very ambitious agenda, and if we take this mission seriously then it is an agenda for system-level change, for 'leadership of place' and 'place shaping'. Bristol Health Partners is not only a technocratic, organisational proposition - it is an opportunity to think, work and act together for the good of our region and the people who live in and around it.

The potential collective impact of the partnership and its members is considerable. Although the formal pooled budget of the partnership is limited, the collective resources available to us are very significant: the scale of our combined spend (services, salaries to supplies chains) extend beyond health structures giving us enormous influence over what life is like for the people of Bristol and the region. The work done by the partnership and its members shapes lives in this city and this region, and it is in these terms that we should be thinking about our impact.

There is a growing body of thinking (and quickly developing political consensus) that collaboration at city region - and not national - level is the key to tackling some of the big challenges that we face today. I think we should embrace this approach and be bold enough to consider and develop research and interventions that affect wellbeing, health and quality of life at city region level, adding to our portfolio of Health Integration Teams (HITs) with deliberately ambitious long term and large scale work. Bristol Health Partners is ideally placed to convene, support and, where necessary, lead this sort of work - and in doing so we can set a standard for the impact that partnerships like ours can have, which may, in time, shape the health practice of cities around the world.

If the partnership is successful, Bristol and the area that surrounds it will be a better place to live, to work and to receive care. Our collective efforts will be coordinated in a way that makes a difference not just to our own organisations, but to the system that we are part of.

Our strategic opportunity

I think the next five years of the partnership should be about leadership of place, real impact on people's lives, and making the city region healthier. Clearly, we will build on and develop the work of the HITs, which will remain the engine room of the partnership and the most obvious way in which the work of the partnership is manifested. But I also think we should have a longer term and broader agenda, and I will be sharing what I think this will look like for the partnership in the New Year.

But whatever the specifics, a successful partnership will lead to:

  • Better health for the people who live in and around Bristol
  • Supporting this, more impact for our research
  • Less inequality of access, provision, and outcome

Delivering healthier lives, earlier prevention of illness and disease, and better integration of healthcare.

As I said earlier, I'll be sharing the new plan for the partnership in the New Year. In the meantime, my sincere thanks to all of you who are involved in the partnership and in the HITs in particular. If you are taking some time off over Christmas and the New Year, enjoy the break - and I look forward to working with you all in the year ahead.

David Relph: what the future holds for the partnership
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