What makes a good partnership agreement — and what makes it work?
by lev pedro & emma baylin & aimie cole - february 2023
This article is for anyone developing a partnership agreement between NHS Integrated Care Boards (ICBs) and VCSE (voluntary, community and social enterprise) alliances as part of Integrated Care Systems (ICS).
It’s based on our work supporting areas to develop their agreements, exploring both the challenges and the factors that make them successful. The learning here also applies more widely to other types of partnership agreements.
The big lesson: process matters most
If we could summarise everything in one line, it would be:
The process of developing the agreement is more important than the agreement itself.
Coming together to define how you’ll work in partnership, what you want to achieve, and how you’ll resolve issues is what builds trust, mutual respect and strong relationships.
Four key enablers of success
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Creating a mutual working culture
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Building good working relationships
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Leadership from both sectors
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Resources to make it all happen
Why these agreements matter
ICSs have been created to bring different parts of the health and care system together more coherently, with the VCSE sector playing a much bigger role in both planning and delivery.
NHS England requires each ICS to have a partnership agreement between the NHS Integrated Care Board and the VCSE alliance. This defines the scope and nature of the relationship, ensuring the sector is embedded in system governance and design.
How we approached this work
NHS England commissioned Lev Pedro & Associates (Lev Pedro, Aimie Cole and Emma Baylin) to:
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Gather insight from areas that have already reached agreement
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Identify what enabled their success and how they overcame barriers
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Collect example agreements and
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Provide targeted support to systems still developing their agreements.
Barriers and enablers
1. Culture
Where trust already exists, culture is a powerful enabler. Where relationships are weak, culture can be a significant barrier.
Key elements of a positive working culture:
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Open and honest conversations
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Shared vision or statement of intent
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Agreed shared values
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Understanding each other’s strengths, pressures and constraints
2. Relationships
Strong, trusted relationships make the process smoother and quicker.
Many systems actually used the process itself to build or strengthen relationships.
Shared values workshops proved particularly valuable — helping both sectors explore what those values mean in practice.
3. Leadership
Having senior champions in the ICB and dedicated leads in both sectors made a significant difference.
Where these roles existed:
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Culture improved
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Resources were allocated more effectively
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The process of drafting and signing off agreements was far smoother
Where they didn’t, agreements stalled.
4. Resources
Developing these agreements takes time, coordination and engagement.
When the VCSE sector had dedicated resource (e.g. funding for coordination roles or alliances), the process was much easier.
Where engagement structures were already in place, they also acted as strong enablers.
Key questions to ask before drafting
Who is the agreement for and why?
How will we secure buy-in?
Write then engage, or engage then write?
How long should it be?
Is there shared vision and values?
What policies or guidance will influence it?
How will it stay “alive”?
Do we have resource to support it?
Does it need formal sign-off?
Can we just reuse another system’s agreement?
Scope, audiences, influence
Use existing VCSE networks and structures
Choose an approach based on the maturity of your VCSE alliance
More detail = stronger foundation, especially if staff change
Involve a diverse mix of stakeholders
e.g. NHS England guidance
Include an implementation plan or follow-up actions
Time, people, events and drafting
Understand ICB legal and committee processes early
No — the process of co-creating it is key. Use other examples only as reference once yours is agreed in principle.
👉 In Wix:
Practical resources that help
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External facilitation of workshops (contact us for support)
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External drafting support
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Example agreements (available via FutureNHS workspace — email: VCSES-manager@future.nhs.uk)
Final thoughts
A good partnership agreement isn’t just a document — it’s the product of building trust, shared vision, values and commitment. Get the process right, and the partnership will follow.
👉 Don’t forget to send your final agreement to:
📧 england.voluntarypartnerships@nhs.net
About Shared Purpose
Shared Purpose works with charities, VCSE alliances and public sector bodies to strengthen collaboration, develop governance, and build strategic partnerships across the health and care system.
👉 Book a call to talk to us about how we can help your organisation shape ICS strategy and delivery.