The importance of being efficacious: English health and social care partnerships and service user outcomes

Helen Dickinson

doi:10.5334/ijic.646

Abstract

The need for health and social care agencies and their professionals to work in partnership is a central component of contemporary English health and social care policy. Partnership is predicated on the notion that this way of working improves services and outcomes for service users. However, as there is little evidence that partnerships improve service user outcomes, some commentators suggest that this indicates either a failure of the policy or a deficit in terms of implementation. This thesis investigates the link between health and social care partnerships and service user outcomes. Rather than adopting the types of rationalist and instrumental approach which the majority of studies in this field have done, the thesis develops a new conceptual framework for partnership which is interpretive and performative. This framework is developed and tested in four exploratory case study sites and concludes that partnership is not necessarily simply an instrument of improvement in a traditional sense. The power of partnership lies in its cultural and symbolic value. This takes partnership beyond traditional discussions of partnership and governance; rather than representing a particular mode of governance, instead arguing that partnership is an active tool of governance.

Highlights

Partnerships take a number of different forms and do not constitute a particular model of care
The need for health and social care agencies and their professionals to work in partnership is a central component of contemporary English health and social care policy
The aim of this thesis was to investigate the link between English health and social care partnerships and service user outcomes

Summary

Introduction

Partnerships take a number of different forms and do not constitute a particular model of care. In practice partnership has been implemented as all of these different modes and through a range of different means. The one commonality is that health and social care partnership are conceptualised as instrumental tools of improvement, introduced in order to bring about positive changes to service user outcomes. An analysis of the policy context indicates that there are a range of reasons that partnerships might be introduced, beyond being a means to bring about better service user outcomes. The thesis identifies four dominant ‘frames’ that seek to explain why it is that health and social care partnerships exist and what it is that they should achieve (see Table 1). Central government has predominantly cited improved service user outcomes as the motivation of these frames, this does not appear to be a central driver

Why are health and social care partnerships necessary?

Implications for integrated care