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  • Author or Editor: Neil Perkins x
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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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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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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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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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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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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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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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Partnership working has been a central feature of New Labour's approach to the delivery of health and social policy since 1997. A number of partnership-based initiatives have centred on reducing health inequalities and improving health. This article reports on the findings from 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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Chapter 4 looks at the evidence about clinical engagement in primary care-led commissioning. Extending and strengthening clinical leadership was one of the key elements of the HSCA12. However, this idea was not new, and this chapter reviews the evidence on the role of clinicians in primary care-led commissioning and how this has contributed to the delivery of healthcare services since the early 1990s. It examines the nature of clinical engagement/involvement in the various primary care-led commissioning models that have been introduced into the NHS. Drawing on a review of the literature and our research on Clinical Commissioning Groups the chapter shows how the extent of clinical engagement has varied between the various schemes. GP commissioners have historically been more successful in influencing the work done by GP practices than in making broader changes to services provided by secondary care. The chapter goes on to explore the claims made both by those involved and in official documents about how greater involvement of clinicians in CCGs – and in particular GPs – will enhance commissioning practice. We test this against evidence from our study of CCGs, showing how the engagement and involvement of GPs requires careful attention to detail. Using a realist approach to evaluation, we highlight the contexts and mechanisms associated with successful – and unsuccessful – GP involvement in commissioning.

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