Our Shared Agreement
Our Shared Agreement is a movement to create a better relationship between the people of Lincolnshire and health and care services
Good health and wellbeing don’t come from services alone - they come from how we work together, how we listen, and how we build trust over time.
We all want the best lives for ourselves and those we care about. Achieving that means creating a different kind of relationship, one where people, communities, and professionals work as equal partners.
Our Shared Agreement brings this to life by helping us to:
- build trust and understanding between people and health and care professionals
- share knowledge, skills, and confidence
- strengthen the relationships that support people to live well
This is not just a programme. It’s a growing movement to reshape relationships across Lincolnshire’s health and care system, together.
Join the movement. Shape it. Live it. Grow it.
Let’s build better relationships - and better lives - together.
The Five Foundations: building relationships that work
At the heart of our Shared Agreement are Five Foundations. These were shaped both by people who deliver care in Lincolnshire and those who receive it.
Each Foundation offers new ways of thinking and working together. They invite us to move beyond problems and processes, and instead focus on strengths, hopes, and what truly matters most to people.
Importantly, each Foundation describes how we relate to one another, not just what we do:
Foundation 1: Being prepared to do things differently
We commit to changing how we work with each other, being open, flexible, and willing to learn so that relationships can grow in new ways.
Foundation 2: Understanding what matters to ourselves and each other
We take time to listen and understand what matters, because meaningful relationships start with genuinely knowing each other.
Foundation 3: Working together for the wellbeing of everyone
We move from “doing for” to working with, building partnerships where people and professionals contribute equally.
Foundation 4: Conversations with and not about people
We prioritise open, honest conversations that include people in decisions—because relationships are built through dialogue, not assumptions.
Foundation 5: Making the most of what we have available to us
We recognise the strengths in individuals, communities, and services—and bring them together through strong, supportive relationships.
Together, these Foundations help shift the culture from transactions and processes to trust, partnership, and shared responsibility.
Bringing relationships to life
Our Shared Agreement isn’t just a set of ideas. It’s about how relationships feel in real life.
When it works well:
- People feel heard, respected, and involved
- Professionals feel connected and able to make a difference
- Decisions are made together, not for each other
- Care is shaped around people’s lives, not just their conditions
This approach reflects a wider shift across Lincolnshire, towards co-production, shared decision-making, and personalised care built on strong relationships.
See the Five Foundations in action
To see how the Foundations are being brought to life in Lincolnshire, CLICK ON EACH STORY LINK below.
Our Shared Agreement stories: Hans and Amanda
Hans' story is a great example of all Five Foundations in action.
After having a heart attack, Hans was feeling overwhelmed and out of control with his health. He had lost hope.
Amanda, a Cardiac Rehabilitation Nurse Specialist, supported Hans using the Patient Activation Measure (PAM).
Using the PAM enabled Amanda to talk with Hans about why he had feelings of being overwhelmed.
Hans: ‘Yes, the process was tailored to me, because Amanda sat and listened to what my lifestyle was, and she asked what I needed.
“And Amanda’s response wasn’t a global “Oh, Hans has had a heart attack – this is what he needs”. Instead we took the time to work out who I was, and she could then offer support based on my needs.”
Amanda: “We talked about how overwhelmed Hans was, and that actually didn’t take much time at all, but that established a baseline for us to work from. And without the Activation Measure, I wouldn’t have known where his knowledge, his skills, or his confidence lay.
“The Activation Measure just gave me a number for that, and a level at which to give him the information he needed. So, the information was tailored in very small sessions, and small bites.”
The outcomes of working in this way
Amanda: “As the time went on, and we approached the end of Hans’ programme, we did another Patient Activation Measure Score, and he had absolutely zoomed through to a Level 4, where he was back in charge, and moving forward with his own health requirements.”
Hans: “The changes I made through working with Amanda gave me positivity, because a lot of things were still very negative. And she gave me hope, in what I had to look forward to.”
How Hans and Amanda used the Five Foundations to guide their work together:
Foundation 1: Being prepared to do things differently
- Amanda used a different approach - the Patient Activation Measure - to establish Hans' ability to manage his own wellbeing, and work out how best to support him to do this.
Foundation 2: Understanding what matters to ourselves and each other
- Amanda took the time to work with Hans to find out what was important to him, what he needed, and what he could do to support himself moving forward.
Foundation 3: Working together for the wellbeing of everyone
- Amanda and Hans worked together, bringing their individual experience, knowledge, skills and resources to the table, to co-create a realistic and workable plan for Hans.
Foundation 4: Conversations with and not about people
- Amanda spent time with Hans, listened to him and got to know him. She involved him at all stages of the process to build his capability and motivition to manage his own care.
Foundation 5: Making the most of what we have available to us
- Amanda's work with Hans uncovered and built on his skills, confidence, and motivation to better manage his health moving forward.
CLICK ON THE IMAGE BELOW to see an illustration of Hans and Amanda's collaboration.
WATCH THE VIDEO about Hans and Amanda's collaboration
Our Shared Agreement stories: Katie
Katie's story is a great example of all Five Foundations in action.
CLICK ON THE IMAGE BELOW to read Katie's story
HOT OFF THE PRESS! The new Our Shared Agreement Z-Card. Grab one now!
We know that lots of you get asked about Our Shared Agreement and the Five Foundations by colleagues and the public. So, to help you in those conversations - and provide useful links to more information and resources - we've created a handy leaflet!
When folded, our new Z-Card leaflet is credit card size (see image above), so easy to slip into your bag or pocket. But when unfolded (see the images below) it provides two full pages of Our Shared Agreement and Five Foundations information, complete with links to case studies and further resources.
If you'd like to get your hands on a Z Card, contact us at lhnt.itsallaboutpeople@nhs.net.
Alternatively, download a PDF version here: Our Shared Agreement Z-Card
FLASHBACK! Our Shared Agreement officially launches in July 2024
Our Shared Agreement officially launched at the It's All About People Conference on 3 July 2024. And the capacity conference audience - a fabulous mix of health and care professionals and experts by experience - were keen to celebrate this major landmark.
The movement continues to grow in strength so make sure you join and support us to make a real difference to health and care delivery across Lincolnshire!
Debbie Barnes, Chief Executive of Lincolnshire County Council, announced the launch of Our Shared Agreement - watch Debbie's announcement below.
