These tips were created for Macmillan Cancer Support, which supports communities of influence in order to improve care and support for people affected by cancer. However, the suggestions should be helpful to anyone wanting to develop a community as a collective voice to influence policy and practice in a chosen area, whether healthcare-related or not.
The tips are based especially on experience with “hybrid communities of influence”, which were formed to bridge gaps between different worlds (e.g. academia, service development, policy) for the benefit of patients/service users.
1. Establish a support team A support team can help a group develop into a cohesive, productive community. In the Macmillan context, we found that this team worked best when it included:
A clinical champion and ideas generator, who ‘gets’ how a community of influence works and is well connected in the relevant field.
Other people, as appropriate, who can help the group make the most of its relationship with the sponsoring organisation (typically a manager or managers from the relevant work area/programme).
Community facilitator, if appropriate. This person is like a “weaver” who talks informally to members between community meetings, connects the group with other influential people, helps it produce documents as one way of sharing its expertise, and generally supports and encourages it in its work.
Narrative writer who can capture the story of the group, demonstrate its achievements and stimulate organisational learning.
Expert administrator who understands the nature of the group and is able to work on his or her own initiative. Not only do they need to do all the usual tasks (e.g. setting up meetings and teleconferences) but also to help the group produce documents, and to collate responses to drafts, arrange online voting on dates and provide web content.
2. Form the group with selection criteria in mind – but be flexible Below are some criteria worth considering. It helps to let people know why they have been selected.
Energy, desire to take part, and potential to develop into strong influencers
Expertise and experience in the relevant field (depends on group purpose)
Hybrid people (e.g. research-active health professionals, or at least a mix of backgrounds within the group)
Desired size of group (depending on its purpose)
Diversity of professions, educational levels and career stages, as appropriate
Geographical spread of members, as appropriate.
3. Link the group into the sponsoring organisation from the start
Respect the independence of the group but invest time in connecting members with specific members of staff in the sponsoring organisation, and make sure that each party knows enough about the other.
Realise that members are free to work with other organisations, but encourage them to acknowledge the sponsoring organisation’s support.
Provide the group with a main contact in the sponsoring organisation and an effective support team.
Establish the group’s relationship with the relevant person in senior management at an early stage so he or she is fully aware of what its members can offer – e.g. providing tangible products and consultancy, and acting as spokespeople.
Consider including the sponsoring organisation in the group’s name.
Allow time for negotiating agreements with the members’ employers.
Consider the group’s communication needs early on – e.g. independent website or shared space on the sponsoring organisation’s website.
4. Establish clear funding arrangements from the start The sponsoring organisation typically needs to provide the following types of funding (and this should be transparent for the group itself):
Bear the cost of the support team (see above).
Provide a budget for the group’s meetings and activities. This will cover some or all of the following: 1. travel and accommodation; 2. time spent by members attending community meetings; 3. any project grants; and 4. other costs, such as external facilitation and ‘consumables’.
Provide project funding as appropriate - it is worth considering a staged funding process, if feasible: 1. Start with a small amount of funding for initial project(s) to build group collaboration and enable the group to coalesce; 2. Provide a second tranche of project funding based on the group’s emerging interests/thinking/collaboration (aligned with the sponsoring organisation’s objectives); 3. Keep an ear open for high-level ideas/products, in case further funding opportunities arise (and make it clear to members early on, if applicable, that there may be additional funding for further joint projects and activities).
5. Work with members to articulate purpose and direction for the group Offer as clear an idea as possible of what the sponsoring organisation expects by when, but also:
Involve members in articulating what they feel most motivated to achieve together, and be prepared for the group’s purpose to evolve over time.
Bear in mind there has to be something in it for them, so it is worth them freeing up time for group activities.
Consider suggesting a “joint product” early on to help knit the group together; this can give members an opportunity to work together on something tangible, develop trusting relationships and gain a sense of achievement.
Make it clear that you are not expecting only tangible products. The group’s biggest achievement might be that it develops a strong collective voice in its field and comes to be perceived as a “go-to group” for policy makers inside and beyond the sponsoring organisation.
6. Cultivate a convivial environment and a sense of group independence Two main aspects are worth considering:
Hold community meetings in a good space for thinking, conversation and networking; overnight meetings tend to work best, with supper and informal gathering possible under the same roof; what worked well for our most recent community was three times a year, with ongoing dialogue via email and phone in between.
Consider offering suitable facilitation of meetings in the early stages, until the group is ready either to choose a chairperson or to work without one. The facilitator needs to: 1. Understand how communities of influence work and resist any temptation to over-manage the group; 2. Foster reflective conversations while also respecting people’s need to feel productive; 3. Help create a collaborative environment – e.g. by enabling people to get to know one another, being able to handle conflict should it arise, and making it clear what records are to be made of the conversations and how they will be used; 4. Understand a new group’s anxiety around structure and purpose, but also encourage them to find their own way of working; (to begin with, members may not know and trust each other and the group’s purpose may seem vague, so a struggle for leadership is likely – but members can be encouraged to stay with this tension for a while, and to view it as a learning opportunity).
7. Consider cultivating relationship with members’ employers This is something we learnt through working with our first hybrid community of influence, whose members were mostly doctors (general practitioners) with university posts. In one case there were numerous face-to-face meetings in Cambridge with the individual and his boss to maintain progress and help all involved see the benefit of the individual continuing to participate in the community.
8. Be in it for the long game Influence takes time to grow, but relationships, once established, can outlive organisational structures and strategies. So the sponsoring organisation needs to:
Ensure that there is sufficient time for the group to establish itself.
Think in terms of years rather than months.
These tips were drafted by Alison Donaldson for Macmillan Cancer Support in 2013. Comments and questions welcome: [email protected]