Forget the current proposals made by the government to change the organisation of the NHS, it’s an improvement in communication and negotiation skills that are needed in the service, according to Huthwaite International business director Alison Morris.

Are you looking to the future or busy dealing with the here and now? While the changes in the NHS continue to unfold, raising questions over job roles, responsibilities and activities, for many NHS employees it’s business as usual, ensuring that the job gets done to the best of their ability against this backdrop of uncertainty.

In particular, those in commissioning roles, procurement or working at the purchaser/provider interface are feeling the pressure. And for a certain number, despite some impressive results, their function or role is no longer seen as necessary in the new landscape.

Recent coverage in the news has increased the focus, and unfortunately the media is currently more likely to pick up on inconsistencies or overspends in negotiated contracts than where millions have been saved and outcomes improved for patients. 

Whatever your views on the “new” NHS, most would agree that there are savings to be made in some areas, without compromising care and maybe at times even improving it. Negotiating agreements that are cost-effective and lead to better patient outcomes is not something just for the future of course - it is happening now and has been for some time. 

However, creating effective agreements between purchaser and provider or procurement and supplier is rarely an easy path and many senior and middle managers within the NHS are expressing concern about the ability of their people – or in some cases themselves - to negotiate as effectively as possible.

There is a growing awareness that such skills are now more crucial than ever.  In a recent survey we carried out, over 95 per cent of respondents said they believed the need for commercial ability, such as negotiation skills, would increase success in the NHS. By learning to negotiate in a confidant way to get the very best deal, NHS professionals are recognising that they can realise major benefits for themselves and the people and departments on whom their decisions impact.

This need for specialist skills affects every stage of the negotiation process. What does “good” really look like during the planning and preparation phases of a negotiation for example? Or at the negotiating table itself? 

That’s assuming there is a negotiation table of course. Sometimes the other party is intentionally kept at arm’s length, with little chance of contact via a face-to-face meeting. If the purpose of this is to reduce the offering to a transactional purchase in a largely commoditised market, then this may well be the most efficient and effective method for one or both parties. However, applying similar tactics in more complex selling/buying decisions can be a recipe for disaster.

Price or value?

In order to achieve the ideal win-win outcome, it is essential to understand the differing needs and issues facing all relevant stakeholders.  Depending on your role within the NHS this will present different challenges.

As the changes in commissioning come into play, it will become increasingly important for providers and suppliers to take the time - and be given the opportunity - to really understand the requirements of the other parties involved, rather than make decisions on assumptions and limited information.

There are lessons to be taken from the traditional seller/buyer interaction here. Successful professionals on the “buy” side, for example in commissioning or procurement roles, know that the more effective the communication between parties, the stronger and more relevant the solution will be. 

It is recognised within the procurement community that reducing the basis on which a buying decision is made to simply price alone is often a flawed approach. Not only might it negatively impact on the central product or service itself, but also risks the organisation losing out on many of the services and other added value offerings a potential supplier has developed.

An attempt to exploit a perceived imbalance in power, on either side of the negotiation, is also likely to be short-sighted. The result of the ‘win/lose’ outcome longer-term typically remains the same: both parties lose. A deal which is unprofitable or unworkable for the supplier or provider may result in them being unwilling or unable to provide the products and services the ‘customer’ wants, so neither gets the outcome it needs. The phrase “no deal is better than a bad deal” holds true here.

Best practice skills and process

So what does “excellent” look like?  How do we create the environment for success on both sides, in such a potentially difficult climate?  And, if a face-to-face negotiation is possible, what are the skills needed to help ensure achievement of the objectives each party is looking for.

We have researched aspects of strategy, tactics and the behaviours of successful, effective negotiators over many years. From this, an evidence-based success model has emerged providing insights and tools to develop the attitudes, processes and behaviours of the exceptional commercial negotiator. Interestingly, whichever side of the table you sit the model is applicable. Findings from the research include:

  • Strategic objectives: it can be very tempting when the pressure is on to just get an agreement that works in the short-term.  Effective negotiators, by contrast, also take time to consider the longer-term impact where relevant, considering all the implications and taking an “in their shoes” approach to anticipating the other side’s position
  • Power: many negotiators fail to realise the impact of their power and that of the other party. They may not realise they have it, use it ineffectively, or abuse the power they have. Understanding and managing the power balance for a specific negotiation, including the consideration of tough no-go decisions, is essential to success
  • Preparation and planning: don’t confuse preparation and planning. An average negotiator convinces themselves they have prepared well, by relying heavily on data, proof sources and statistics in the preparation phase, yet they fail to plan how to use this information to the best advantage. Excellent negotiators explore a much wider range of possible trades and linkages: they also understand how to leverage these and know the cost of possible concessions
  • Face-to-face skills: great negotiators have a wide portfolio of behavioural skills and use a surprisingly consultative style. This is based on understanding needs, maintaining clarity and building trust, and at the same time dealing firmly with aggressive or unreasonable behaviour by the other side

The Huthwaite research has also exploded a number of common myths about what makes a successful negotiator: For example:

  1. The conditional “if you do this, I’ll do that” form of trading is only one part of a much more complex set of skills today. 
  2. Skilled negotiators, whether “buying” or “selling”, are good listeners and ask twice as many questions as the average negotiator. 
  3. Contrary to popular belief, they are not “poker-faced”: they express feelings or emotions when appropriate, encouraging openness and creating a climate of trust.
  4. A talented negotiator avoids “argument dilution”. Our educational culture has taught us to present as many arguments as possible to support our case: not surprisingly therefore, this is precisely what average people do in negotiation. The key to success is to use one strong argument and repeat it as necessary. Only if it is undermined should a negotiator introduce a second reason to support their position. The best negotiators refuse to dilute a strong argument with a weak one.