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The UK government’s reforms of the NHS and public health system require partnerships if they are to succeed. Those partnerships concerned with public health are especially important and are deemed to be a ’good thing’ which add, rather than consume, value. Yet the significant emphasis on partnership working to secure effective policy and service delivery exists despite the evidence testifying to how difficult it is to make partnerships work or achieve results.

Partnership working in public health presents the findings from a detailed study of public health partnerships in England. The lessons from the research are used to explore the government’s changes in public health now being implemented, most of which centre on new partnerships called Health and Wellbeing Boards that have been established to work differently from their predecessors.The book assesses their likely impact and the implications for the future of public health partnerships. Drawing on systems thinking, it argues that partnerships can only succeed if they work in quite different ways. The book will therefore appeal to the public health community and students of health policy.

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Health systems everywhere are experiencing rapid change in response to new threats to health, including from lifestyle diseases, risks of pandemic flu, and the global effects of climate change but health inequalities continue to widen. Such developments have profound implications for the future direction of public health policy and practice.

The public health system in England offers a wide-ranging, provocative and accessible assessment of challenges confronting a public health system, exploring how its parameters have shifted and what the origins of dilemmas in public health practice are. The book will therefore appeal to public health professionals and students of health policy, potentially engaging them in political and social advocacy.

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This chapter presents qualitative research findings of the views of frontline practitioners and service users of public health partnerships in four selected tracer issues. The topics examined include: the benefits and barriers to partnership working, the effectiveness of partnerships in providing a more seamless service for users, and what is needed to improve services for users through the aegis of partnership working.

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The chapter reports on the findings of a systematic review of the impact of partnership working on public health, and considers whether these partnerships have delivered better health outcomes for local/target populations. It finds that there is little evidence that partnerships have produced better health outcomes for local/target populations or reduced health inequalities.

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Partnership working is central to British public policy. Few challenges facing government can be tackled successfully without working across boundaries and in partnership. Public health issues are particularly complex in this respect and yet little is known about public health partnerships. The research reported in this book seeks to go some way to closing the knowledge gap employing the notion of a public health system to explore the issues raised. The book brings the discussion up-to-date by examining the evolving public health system in England and the major changes introduced in April 2013. These have introduced new partnership forms that remain to be tested. Our research offers useful insights and learning points.

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This chapter discusses the various theories and concepts of partnership working and explores what partnership working is, the opportunities and barriers to working in partnership, and the various modes of governance underpinning partnerships. It argues that a networked approach to the governance of partnerships is needed based upon systems thinking to tackle the complex ‘wicked issues’ found in public health.

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In the light of the research presented and the public health changes underway in England, assesses the future prospects for public health partnerships which will become more complex and challenging. This chapter argues for a different approach which emphasizes the importance of relationships and suggests the need for less attention being given to structures and order. Partnerships in future need to be much more flexible and task oriented, engaging with those who can effect change on the frontline. The public health challenges facing society have few obvious or clear-cut solutions. Partnerships need to experiment and take risks to find out what works and why. If this requires being a little messy in how the work gets done then that may be desirable. The chapter offers some learning points for effective partnership working.

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This chapter presents the research findings, through qualitative research, derived from the views of senior practitioners and their perceptions of the effectiveness and efficacy of public health partnerships. Interviewees include: Directors of Public Health, Directors of Commissioning, Councillors, and other senior public health practitioners.

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Chapter 6 describes the changing context for partnership working in public health following the UK coalition government’s plans for returning lead responsibility for public health in England to local government while also creating a new agency, Public Health England, to provide support and national system leadership. The changes, contained in the Health and Social Care Act 2012 and introduced in April 2013, reinforce the importance of partnership working while introducing new partnership forms that are yet to be tested and evaluated. The new health policy landscape is described and an interim assessment of progress provided.

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This book sets the scene for the series by comprehensively assessing and critiquing the current state of the public health system in England. It places contemporary challenges and concerns in their historical context, tracing the dominant influence of a medical paradigm on the public health profession and exploring how this has given rise to difficulties for those who subscribe to social or structuralist paradigms. The history of public health is marked by struggles between these competing perspectives and recent policy developments have pointed in contrasting directions. This chapter introduces the various issues that will be tackled in subsequent chapters.

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