This characteristic of being an inverted version of Dr Who’s Tardis, of being ‘large on the outside’, in terms of reach, reputation, influence, etc., but ‘small on the inside’, in terms of people and resources and/or the way the organisation is internally organised, segmented or shaped, is a characteristic of many collaborative initiatives or, like The Big Issue, single organisations that need to collaborate to get things done.
For example the Hurley Group, a multi-practice partnership offering health services, has made itself ‘bigger on the outside’ by partnering with 18 general practices in 10 London Boroughs. Its significant presence within London has helped it increase its profile and influence and the scope and quality of its work, so enhancing the health services available to its 100,000 registered patients.
By building relationships and working collaboratively with the wide range of complementary agencies, authorities and social enterprises it overlaps, intersects with and lies beside, the multi-practice has been able to offer new and innovative services in a wide range of areas. These include asylum seeker and substance misuse services, school health and anti-bullying education, and initiatives that seek to address the wider social and community issues impacting upon health and wellbeing.
By making itself ‘smaller on the inside’ through cutting out duplication of resources and sharing administrative support services, medical facilities and equipment, the multi-practice has been able to deliver its services more efficiently.
Also, by minimising its management layers and making its internal organisational segments small scale and local, the multi-practice has been able, consistent with its aims and purpose, to empower GPs to take responsibility for their localities and make decisions and take actions that benefit their patients.
Keeping the organisational structure small scale and locally segmented, based upon the size of a traditional GP practice, encourages the multi-practice's GPs to engage meaningfully with patients, develop productive relationships with complementary local groups, agencies and businesses, and identify and take advantage of the synergies and opportunities that arise as a result. It also reassures the local population that medical resources have been allocated to their area and that these can be accessed as and when needed and, importantly, accessed via a human face.
In short, by creating a small scale segmented internal organisational structure focused upon localities, the multi-practice has created protected spaces which, whilst remaining part of the greater tapestry of the partnership, allow those working within them to think and act in ways best suited to the localities served.
Large global organisations, such as the United Nations Development Programme, work in a similar way.
They are large on the outside, with gigantic recognition and presence, which allows them to engage with and be open to many influences and potential sources of knowledge, experience, expertise and resources.
In terms of their intrinsic internal organisational structures, however, they tend to favour regional or local projects that have their own ring-fenced resources and, importantly, recognisable and accessible human faces. As with the Hurley Group example given above, this encourages those working within the projects to engage with the local population and complementary local agencies and groups. It also, again as per the above example, provides the space within which local managers, workers and volunteers can feel empowered to take advantage of the synergies and opportunities that emerge from their developing local relationships. (And once again, keeping things regional and local reassures people that they have not been forgotten and that their needs are being addressed.)
For more about collaboration go to: Sleeping-with-the-Enemy-Achieving-Collaborative-Success-2nd-Edition