Table 4 Explanations for findings in the Inter-agency Collaboration Framework [68] (shown in Fig. 3)

Task omission (3.1)

Activities which are important to the collaborative objectives are not carried out [73]

“there’s been no support I’ve been all on my own’, many, many people say that from beyond Greater Manchester” (S05-F01)

Task repetition (3.1)

Organisations separately carry out actions which need only be done by one [73]

“trying to work through where we are duplicating work again and again” (S04-F03)

Appreciation of interdependence (3.2)

Organisations have similar goals but operate with different functions in different sectors [115, 116]

“the voluntary sector work, even… some of the most clinicians I respect the most… think of it as being non-clinical… not as experts … so there was a lot of people that could have been plugged into really good local, targeted voluntary sector organisations” (S12-F01)

Domains of independence (3.2)

Organisations define activities as their specialist domain [115, 116]

“we’re not just another charity you are that person that organisation fulfilling that statutory duty and that statutory duty should dovetail with the clinical mental health support and that does need to be recognised … It was a very difficult to get any acknowledgment of the existence of ourselves as an organisation with that expertise” (S05-F01)

Resource dependency (3.3)

Service delivery interactions are fundamentally dependent upon acquiring resource [105]

“there was confusion with the centre around what … money we would need and where it would come through” (S03-F01)

The fulfilment of routine clinical care (3.3)

Officials may be reluctant to permit new work which interferes with the delivery of existing programmes

“that was tricky… giving up psychological therapy staff… there are organisational commitments to which they are attached and IAPT targets” (S05-F06)

Change challenged existing practices of funding, tendering, staffing (3.4)

Culture can influence how strategy is made [117]. Change can challenge existing practices and values [118]

I don’t feel I need to worry about competitions… my job becomes one of finding the legal and other mechanisms to allow people to cooperate and work together… if I can get people to cooperate why would I waste my time [with] a convoluted procurement programme? (S03-F01)

We had to absolutely get staff in and second staff from other organisations… the whole… system that we are involved in doesn’t allow that to happen (S05-F06)

Initial broad vision… with ambiguity around enactment, enabled collaboration (3.5)

A broad vision generates more momentum than blueprints. Ambiguity can make negotiation easier, serving as “the grease that allows decision-makers to co-operate” (p36 [119])

The main goal… we all agreed… was… minimising long-term… psychological difficulties… how we achieve it… was… flexible… I’m not so sure anyone… explicitly said ‘this is what we’d like you to do’. (S01-F01)

The response phase witnessed some debilitative cross-checking (3.9)

“Sooner or later, someone or some organisation, will be offended either by the actions of another organisation or by what a core group has committed it to. On the other hand, paying serious attention to accountability can be almost as debilitating, because it implies a need for a continual process of checking in both directions” (p8 [120])

the pathways document… that was the first… real test of collaboration… everybody was wanting to just sort of tweak… odd words and nuances… somebody should have said… stop, let’s just get it out… Whereas… we were all… still trying to be a bit too polite (S02/F03)

We thought we’d made a decision but it then had to be sense checked by somebody else who said yes but it had to go through them and we didn’t quite understand why … at the time it felt interminable (S01/F01)

The HSCP provided hierarchical and brokering functions when the collaborative inertia was experienced (3.10)

A hierarchical model can apply where organisations with common ties are asked to work jointly in a way that would not usually occur on a voluntary basis [121]. This approach may depend on an executive body using its “position in the flow of resources to specify the nature of programmes and linkages at subordinate levels” [68]

there’s… inevitably some competition… some… sense of… whose view is best when there are differing views… there was… a little bit of… tension between providers… a bit of reverting to type… that was brokered… by the partnership and by the commissioners (S02/F03)