DFG Roadshow 19
                     Conflicts & 
Friendships
A Relationship Perspective
 DFG Roadshow Oct 2019
National Body for Home Improvement Agencies
Improving Delivery of the Disabled Facilities Grant
DFG is 
Process Heavy OT
Assessor
 OT responsible for 
establishing clinical 
need.
 GO responsible for 
protecting the public 
purse LA 
 HIA CW responsible HIA
for advocating on 
Facilitator GObehalf of the client
Enforcer
Split Legal responsibilities 
 Housing authorities have the mandatory duty for 
Cost-Benefit the DFG  Social Care has duties to older & disabled 
Conflicts people & disabled children. Health has a duty to respond all at the point of 
need 
Public Housing
Health Health Planning
Social DFG
Care Costs and benefits split:  Capital costs - Central Govt and 
3rd Housing Authorities 
sector  Revenue costs - Housing 
Services and budgets split: Authorities and Social Care

 DFG, Community Equipment, Sensory Impairment, Overall benefits - Health and Social 
Assistive Tech, Repairs, Wheelchairs. Care
 Overly complex for customers & professionals
Commissioner Hierarchical, transactional 
-Contractor leadership
Tensions
 Essentially Parent/Child relationship
 Referee and fixer of disputes
 Multiple contracts to monitor
 Output not outcome drive
 Process costs/micro management 
stifles change & innovation
 Risk are unfairly distributed
 Quality VS Cost trade-offs.
OT
HIA LA CustomersGO
Public 
Health HousingHealth
Social DFG Customers
Care
Costs of 

conflict 1700 FTEs costing £76.5M (15% or 17% with man costs) Local Government Ombudsman activities
 120-150 statements/year
 1% but 50% higher than £1 spent on other 
council services
 10 times more likely per household (0.3% vs 0.04%)
 Significant levels of work related stress
 High in Health, Social care & local government
 1/3 of all ill health at work
 Leading to average 31 day sickness
 Sclerotic processes  
Let’s Pull  Shared Commitment to 
Together! Integrated Care & Support 
(2013)
 Care Act Duty to Collaborate
 Better Care Fund (2014)
 National Memorandum of 
Understanding on Health & 
Housing (2015 & 2018)
 Collaborative HIA (2016)
A new way 
to engage?
 Collaborative
 Co-produced
 Person-centred
An  Provides a vehicle to share 
Alliance risks, responsibilities & opportunities
 Provides a way of working 
based on alignment around 
outcomes and commitment to 
principles & behaviours
 Not a legal entity as Alliance 
participants retain their own 
identity  & internal controls.
Alliance Contract
Traditional contract Alliance 
Alliance Governance Arrangements
Contract Risk-sharingRewards
Structure Performance
Alliance Contract 
 One contract, one between all 
performance framework parties
 Contract sets out agreed 
outcomes and 
relationships
 Strong Relationships & 
Trust
 Aligned objectives, shared 
risks P
 Shared Responsibility P1 2 P3 P4 P5
drives improvement
 Success judged on Alliance Participants
performance overall 
 Decisions are made 
against principles
Collective 
responsibility 
for all risks
Act 
according  to ‘Best for 
Alliance Service’ 
values & Decisions
Behaviours
Alliance 
Principles Alliance Unanimous Appoint on decisions on 
best person all key 
basis issues
Open Book ‘ No Fault, 
Accounting & No Blame ‘ 
Transparency Culture
 Alignment of Goals:
Organisational  Will achievement of Alliance Goals lead 
Alignment to achievement of our own Goals?
 Alignment of Drivers:
 Will our own strategic objectives be met 
by being a member of the Alliance?
 Alignment of Commitment:
 Are we prepared to make collective 
decisions & play our part in 
implementing them?
 Alignment of Governance:
 Does the decision making, policy setting 
& assurance role of the Alliance fit with 
our own governance?
Integrated 
Governance Commissioner
 Commissioner as Owner
Sets mandate, outcomes, risk-strategy.
Focus on system & Behavioural leadership
Alliance Leadership Team (ALT)
 Alliance Leadership Team
Senior members (including commissioner) 
with authority to commit on behalf of their Alliance Management Team (AMT)
organisations; One  Leadership Forum to led by Alliance Manager
replace contract monitoring
Wider Integrated Team
 Alliance Management Team
Key people with subject expertise from each 
of the participating organisations P1 P2 P3 P4 P5
Delivery Delivery Delivery Delivery Delivery 
Teams Teams Teams Teams Teams
 Alliance Manager
Runs the alliance (‘go to’ person or CEO)
14
Collaboration 
is….
 Making decisions 
together
 Implementing 
those decisions
 Being jointly 
accountable the 
results
 Drives Collaboration & Innovation
Alliance  Values Different Perspectives & diversity of provision
Contracting  Democratic and equal: Everyone has 
a say, decision making is shared
 Single Risk Sharing Contract
 Integrated governance; principle based 
decision making
 Performance Framework focused on 
whole system outcomes
 Financial risk share through gainshare 
& pain-share mechanism
Alliance 
Contracting  The Targeted Prevention Alliance 
Stockport
A little closer to  6 Community & Housing 
Home organisations
 The Lambeth Living Well 
Collaborative
 2 Charities, Foundations Trust & 
ASC 
Conclusions  Risk (and opportunity) share not 
risk allocation
“we thought we  The collective dynamic of several 
were good at interdependent features is unique 
partnerships. Now to alliancing
we are working in  

an alliance we Collaborative leadership skills 
realise we hadn’t needed – from commissioners 
especially
really collaborated 
before”  Build relationships strong enough 
to have hard conversations
Alliance Logic Chain
Inputs Activities Outputs Outcomes Impacts
Switch  Alliance  Alliance  Greater  Fewer conflicts, 
Resource strategy Principles, number of complaints & 
from contract  Governance Values & people stress.
management structure Behaviour helped to  Greater 
to service  Alliance  Organisational stay well at Systemic 
improvement members Alignment home. Resilience
 Alliance  Financial  Reduced  Better 
agreement framework Financial Communities
Risks
Interested in Exploring Alliancing?
[email protected]
Dr Linda Hutchinson LH Alliances: http://lhalliances.org.uk/